Skip to main content

Full text of "The new ICD-9-CM diagnosis-related groups classification scheme"

See other formats


Health Care 
Financing 



Contracts Report 



The New ICD-9-CM Diagnosis-Related Groups 
Classification Scheme 




Health Care Financing Administration 



health Care 
financing 

Grants and 
Contracts Report 



The Office of Research and Demonstrations, Health 
Care Financing Administration, directs more than 300 
intramural and extramural research, demonstration, and 
evaluation projects. These projects seek alternative ways 
to finance, organize, and deliver health services, as well 
as assess the impact of Federal programs on health care 
costs, providers, and beneficiaries. The Health Care 
Financing Grants and Contracts Report series presents 
the final reports from selected extramural projects 
funded by the Office of Research and Demonstrations. 
The statements and data contained in each report are 
solely those of the contractor or grantee and do not 
express any official opinion of or endorsement by the 
Health Care Financing Administration. 



The New ICD-9-CM Diagnosis-Related Groups 
Classification Scheme presents the results of grants from 
the Health Care Financing Administration to the Health 
Systems Management Group of Yale University's 
School of Organization and Management for develop- 
ment of an inpatient classification scheme that divided 
patients into clinically coherent groups based on the 
consumption of resources. These are referred to as 
Diagnosis-Related Groups (DRGs). A patient's episode 
of care served as the unit of analysis. The creation of 
467 DRGs was achieved through the analysis of hospital 
discharge data. Patients were classified into these groups 
according to principal diagnosis, secondary diagnoses, 
operating room procedure, presence of a substantial 
comorbidity and/ or complication, age, and discharge 
status. 



HealthCare 
Financing 

Grants and 

Contracts 

Report 

The New ICD-9-CM 
Diagnosis-Related Groups 
Classification Scheme 



U.S. Department of Health and Human Services 

Health Care Financing Administration 
Office of Research and Demonstrations 
Baltimore, Maryland 
September 1983 



For sale by the Superintendent of Documents, U.S. Government Printing Office Washington, U.C. 20402 



This report was prepared under the Health Care Financ- 
ing Administration (HCFA) grant numbers 95P 
97499/ 1-01 and 95P 97499/ 1-02 between HCFA and 
Yale University School of Organization and Manage- 
ment, Health Systems Management Group (HSMG), 
Robert B. Fetter, Principal Investigator. The Project 
Officers for these grants were Gail Lasdon, Julian Petten- 
gill, and James Vertrees, staff members of the Office of 
Research and Demonstrations. This work was made 
possible by the availability of data from the Professional 
Activities Study of the Commission on Professional and 
Hospital Activities and data from the New Jersey State 
Department of Health. Inquiries regarding the software 
for DRG assignment should be made in writing to Ann 
T Freedman, Yale School of Organization and Man- 
agement, P.O. Box 1A, New Haven, Conn. 06520. 



i 



Acknowledgments 



Many individuals provided advice, guidance, and 
support to the Health Systems Management Group 
staff in the development of this project. These include 
Gail Lasdon, Julian Pettengill, and James Vertrees, 
Project Officers, Health Care Financing 
Administration, our subcontractor, the Commission on 
Professional and Hospital Activities; the ICD-9-CM 
DRG Steering Committee; the Clinical Council on 
Classification; the New Jersey State Department of 
Health; the New Jersey Commissioner's Physicians 
Advisory Committee; and the Hospital Care 
Subcommittee of the Technical Advisory Committee 
on Health Data. 



June Kinney and Faith Goldschmidt from the New 
Jersey State Department of Health participated in 
several Steering Committee Meetings and worked 
closely with the New Jersey Physician Panels. Joan 
Laughran provided consultation to the ICD-9-CM 
Steering Committee on medical record issues. Ted 
Klastorin contributed to the methodology used in the 
replication substudy. Completion of this project relied 
heavily on the programming expertise of Enes Elia 
and Robert Elia and administrative support of Maria 
DeMusis and Ann Palmeri. 



iii 



Health Systems Management Group 
ICD-9-CM DRG Project Staff 

Principal Investigator: 
Robert B. Fetter 

Co-Principal Investigator: 
John D. Thompson 

Associate Director for Research: 
Richard F. Averill 

Project Director: 
Ann T. Freedman 

Physician Consultants: 
John Hughes, M.D. 
Jeffrey L. Lichtenstein, M.D. 
Robert L. Mullin, M.D. 
David Silverstone, M.D. 

Programming Staff: 
Robert Elia 
Enes Elia 
Pamela Miller 

Research Assistants: 
Jean Freeman 
Jeanette Ryan 

Administrative Support: 
Maria DeMusis 
Mary Luciano 
Ann Palmeri 

Editorial Assistance: 
Dianne Cesaroni 

Graphic Design: 
Steven D. Freedman 
Carry Johnson 



iv 



Contents 



Executive Summary l 

Section 1: Overview 3 

Historical perspective 3 

Rationale 3 

Organization of project 6 

Enlarged data base 7 

Clinical input 7 

DRG characteristics 8 

Purpose of final report 8 

Section 2: Methodology 9 

Data base 9 

Sub-sampling plan 1 1 

Variables used in the construction of DRGs 12 

Formation of DRGs using clinical input 38 

Section 3: Construction of diagnosis-related groups 69 

Major Diagnostic Categories 69 
An Example of Major Diagnostic Category 1 1 : 

Diseases and disorders of kidney and urinary tract 69 

Section 4: Replication substudy 96 

Introduction 96 

Methods 96 

Material and support provided to teams 96 

Results 97 

Signs and symptoms for painful respiration 106 

Findings 106 

Implications for Inter-institutional comparisons 106 

Technical reference 121 

Section 5: Concluding remarks 125 

Future implications 125 

Limitations 126 

References 127 



V 



Appendixes 



Contents 

I: Contributors 

II: Summary tables of diagnosis-related groups and Major 

Diaenostic erouD tree diagrams 
III: MEDPAR version of diagnosis-related groups 
IV: Reference lists for Schemes A, B, and C 
V: Summary of services provided by the Commission on 
Professional and Hospital Activities under the 
Subcontract 
VI: List of abbreviations and glossary of terms 
VII: Available materials from the ICD-9-CM project 
VIII: Summary of New Jersey Physicians' Comments, Summer 
1981 

IX: Record layouts for all data sets used to construct ICD-9- 
CM DRGs 

X: Uniform Hospital Discharge Data Set, Final Summary 

Report of activities, 1975-1978, U.S. National Committee 
I on Vital and Health Statistics 
XI: Addendum to substantial comorbidity and or complication 
table 

XII: Proposed modification to the classify algorithm 
XIII: Automated interaction detector method of Sonquist and 
Morgan 

List of Tables 

1.1. Criticisms and misconceptions about the 383 version of DRGs 

2.1 Universe of hospitals for the United States 

2.2 Universe of Commission on Professional and Hospital Activities 
study hospitals 

2.3 Subsamples drawn for Major Diagnostic Categories 

2.4 Uniform Hospital Discharge Data Set elements 

2.5 Data base elements 

2.6 Additional variables explored or used in the formation of 
diagnosis-related groups 

2.7 ICD-9-CM operating room procedure codes 

2.8 ICD-9-CM diagnosis codes that represent substantial 
complications or comorbidities when present as secondary 
diagnoses 

3.1 Listing of twenty-three Major Diagnostic Categories 

3.2 Relationship between ICD-9-CM categorization and Major 
Diagnostic Categories 

3.3 An example of infectious and parasitic diseases, ICD-9-CM 
diagnosis codes assigned to each Major Diagnostic Category 

3.4 Listing of the assignment of ICD-9-CM diagnosis codes with 
English descriptions to Major Diagnostic Category 11: Diseases 
and disorders of the kidney and urinary tract 



Examples of operating room procedures for Major Diagnostic 
Category 11: Diseases and disorders of the kidney and urinary 
tract 

Descriptive summary of DRGs 302-333 Major Diagnostic 
Category 1 1: Diseases and disorders of the kidney and urinary 
tract 

Preliminary operating room procedure listing used in the 
conceptualization of initial operating room procedure categories 

Step one of preliminary assignment to operating room procedure 
categories 

Preliminary principal diagnosis listing used in the 
conceptualization of initial categories 

Step one of preliminary assignment of principal diagnoses 

Major Diagnostic Category 11: Diseases and disorders of the 
kidney and urinary tract, kidney, ureter, and major bladder 
category 

Major Diagnostic Category 1 1: Diseases and disorders of kidney 
and urinary tract 

Operating room procedure category hierarchy ranked in 
descending order of importance for Major Diagnostic Category 
11: Diseases and disorders of the kidney and urinary tract 

Independent variables reviewed in the partitioning process for 
kidney, ureter, and major bladder 

Kidney, ureter, and major bladder operating room category 
partitioning on the basis of principal diagnosis 

Suggested partitioning (4 groups) of kidney, ureter, and major 
bladder operating room procedure category on the basis of 
principal diagnosis 

Definition of malignancy used in partitioning of kidney, ureter, 
and major bladder operating room procedure category 

Independent variables reviewed in the partitioning process for 
kidney, ureter, and major bladder without malignancy 

Kidney, ureter, and major bladder without malignancy 

Independent variables reviewed in the partitioning process for 
infection 

Infection 

Independent variables reviewed in the partitioning process for 
infection with Age 0-17, and with Age 18 and over 

Infection 

Number of discharges, mean and standard deviation of length of 
stay, and coefficient of variation by DRG within each 
classification 

Number of discharges cross classified by Scheme A and Scheme B 
Number of discharges cross classified by Scheme A and Scheme C 



4.4 Number of discharges cross classified by Scheme B and Scheme C 108 

4.5 Summary of agreement measures 109 

4.6 Expected difference in length of stay per case by type of hospital 

and classification scheme HO 

4.7 Number of cases, case-mix proportion, average length of stay for 
Northeast hospitals, average length of stay for all hospitals, and 
the difference in average length of stay between Northeast 

hospitals and all hospitals, by DRG and classification scheme 1 1 1 

4.8 Number of cases, case-mix proportion, average length of stay for 
North Central hospitals, average length of stay for all hospitals, 
and the difference in average length of stay between North 
Central hospitals and all hospitals, by DRG and classification 

scheme 112 

4.9 Number of cases, case-mix proportion, average length of stay for 
Southern hospitals, average length of stay for all hospitals, and the 
difference in average length of stay between Southern hospitals 

and all hospitals, by DRG and classification scheme 113 

4.10 Number of cases, case-mix proportion, average length of stay for 
Western hospitals, average length of stay for all hospitals, and the 
difference in average length of stay between Western hospitals and 

all hospitals, by DRG and classification scheme 114 

4.11 Number of cases, case-mix proportion, average length of stay for 
non-teaching hospitals, average length of stay for all hospitals, and 
the difference in average length of stay between non-teaching 

hospitals and all hospitals, by DRG and classification scheme 115 

4.12 Number of cases, case-mix proportion, average length of stay for 
minor teaching hospitals, average length of stay for all hospitals, 
and the difference in average length of stay between minor 
teaching hospitals and all hospitals, by DRG and classification 

scheme 116 

4.13 Number of cases, case-mix proportion, average length of stay for 
major teaching hospitals, average length of stay for all hospitals, 
and the difference in average length of stay between major 
teaching hospitals and all hospitals, by DRG and classification 
scheme 

4.14 Number of cases, case-mix proportion, average length of stay for 
small (< 100 beds) hospitals, average length of stay for all 
hospitals, and the difference in average length of stay between 

small hospitals and all hospitals, by DRG and classification scheme 118 

4.15 Number of cases, case-mix proportion, average length of stay for 
medium (100-399 beds) hospitals, average length of stay for all 
hospitals, and the difference in average length of stay between 
Northeast hospitals and all hospitals, by DRG and classification 

scheme 119 

4.16 Number of cases, case-mix proportion, average length of stay for 
large (400 + beds) hospitals, average length of stay for all hospitals, 
and the difference in average length of stay between large 

hospitals and all hospitals, by DRG and classification scheme 120 



viii 



List of Figures 

1.1 Single diagnosis method 4 

1.2 Professional activity study method for each of 349 diagnostic 5 
groups 

2.1 Geographic regions in the United States 10 

3.1 Major Diagnostic Category II: Diseases and disorders of the 74 
kidney and urinay tract, medical partitioning 

3.2 Major Diagnostic Category 11: Diseases and disorders of the 75 
kidney and urinary tract, surgical partitioning 

3.3 Length-of-stay distributions for patients in Major Diagnostic 77 
Category 1 1: Diseases and disorders of the kidney and urinary 

tract 

3.4 Length-of-stay distributions for patients in operating room 85 
procedure category, kidney, ureter, and major bladder 

3.5 Length-of-stay distributions for medical patients with an infection 92 

4.1 Comparison of classification schemes: Surgical partitioning 98 

4.2 Comparison of classification schemes: Medical partitioning 99 

4.3 Operating room procedure codes included in the major chest 102 
surgical group by Scheme A, the resection surgical group by 

Scheme B, and the invasive, radical surgical group by Scheme C 

4.4 Diagnosis codes included in any one of the bronchitis/asthma 103 
diagnostic groups formed by Teams A, B, and C 

4.5 Diagnosis codes included in any one of the pneumonia diagnostic 105 
groups formed by Teams A, B, and C 



ix 



The New ICD-9-CM 



Diagnosis-Related Groups 
Classification Scheme 

Executive Summary 

Hospitals are under increasing pressure to control 
patient care costs through the adoption of effective 
management techniques such as those commonly 
employed by manufacturing firms. It is often asserted 
that the application of such methods will result in 
both increased operating efficiency and quality of 
patient care. For these methods to produce the 
desired results, it is necessary that the production of 
the patient care process within an institution be well 
defined in terms of the goods and services produced 
and utilized. 

A system for describing hospital production has 
been developed and is referred to as Diagnosis- 
Related Groups or DRGs. The DRGs operationally 
define the products of the hospital in terms of classes 
of patients with similar expected patterns of resource 
use. Each group is defined in terms of one or more of 
the following variables which appear on the patient's 
discharge abstract: principal diagnosis, operating room 
procedures, comorbidities and complications 
(secondary diagnoses), age, sex, and in a few cases 
discharge status. As such, the DRGs represent a 
multivariable system for classifying hospital 
discharges from acute care hospitals into patient 
groups or types of cases with similar sets of services. 

The latest version of the DRGs, based on ICD-9- 
CM diagnosis and procedure codes, takes into 
account problems raised with previous versions as a 
consequence of attempts to use them, and the variety 
of applications which have been undertaken and are 
contemplated. Under this current revision, all 
principal diagnosis codes are condensed into 23 
mutually exclusive and exhaustive Major Diagnostic 
Categories (MDCs). The category to which a 
particular diagnosis is assigned is a function of the 
organ system it predominantly affects or the specialist 
who would typically provide care. Diseases that tend 
to be diagnosed and treated in similar ways by similar 
specialists are aggregated in the same MDC regardless 
of etiology. Each hospital discharge is assigned to one 
and only one MDC based on its principal diagnosis 
code. 

With few exceptions, each MDC is then partitioned 
on the presence or absence of a procedure performed 
in the operating room. (All ICD-9-CM procedure 
codes were initially reviewed by clinicians and a list 
constructed of those procedures generally requiring 
an operating room.) Discharges with at least one 



by the ICD-9-CM Project Staff, Health Systems 
Management Group, Yale University, School of 
Organization and Management 



operating room (OR) procedure are referred to as 
"surgical" hospitalizations and those with no OR 
procedures as "medical" hospitalizations. In most 
MDCs, medical hospitalizations are then partitioned 
into clinically coherent groups or principal diagnoses 
and surgical hospitalizations into groups of operation 
room procedures referred to as procedure categories. 
These procedure categories are hierarchical based on 
intensity of resource consumption. A discharge with 
multiple operating room procedures is assigned to the 
surgical group based on hierarchy. 

Depending on the MDC, diagnostic groups 
(corresponding to medical hospitalizations) and 
procedure categories (corresponding to surgical 
hospitalizations) may be further partitioned on the 
basis of age, the existence of comorbidities and 
complications, and, in a few cases discharge status. 
Some procedure categories are also partitioned on the 
basis of principal diagnosis. A compound variable, age 
70cc, is used extensively throughout the system. This 
is a dichotomous (2 level) variable which takes on the 
value "yes" if age> =70 and/or there are substantial 
comorbidities or complications and "no" otherwise. 
Substantial complications and comorbidities are 
defined as those conditions which, in the judgment of 
the clinicians constructing the system, would be likely 
to increase the length of stay for 75 percent of the 
patients by at least one day. 

The current group definitions differ from earlier 
versions in terms of structure and content as well as 
diagnostic and procedural coding. The most 
significant changes result from 1) the redefinition of 
the Major Diagnostic Categories in terms of organ 
system, 2) the restriction that surgical categories 
contain only operating room procedures related to the 
principal diagnoses in their respective MDCs, and 3) 
the designation of specific secondary diagnoses as 
"significant comorbidities and complications." 

The project staff believes these modifications have 
considerably enhanced the clinical coherence of the 
DRGs. As currently constructed, they provide 
hospital administrators and physicians with a powerful 
mechanism to understand and control hospital costs 
and quality of care delivered. Specifically, total costs 
within an institution can be broken down not only by 
type of product but also by type of output. Control 
systems can, therefore, by designed to monitor the 
production process in a manner far more precisely 
and comprehensively than has been previously 
possible. 



1 



Section 1: Overview 
Historical perspective 

Over a decade ago, hospitals in this country began 
facing the rapidly increasing complexity and sharply 
rising costs of medical care. Improved methods for 
analyzing and monitoring institutional performance 
became necessary. By the late 1960's research in 
developing utilization methodologies was well 
underway at Yale and other major research 
institutions. From such research, the underpinnings of 
this report were established. 

The Diagnosis-Related Groups (DRGs) were first 
designed and compiled at Yale University's Center for 
Health Studies in the late 1960's. This research 
accomplishment pulled together much of the work 
that had occurred up to that point. The initial 
motivation for developing DRGs was to create 
useable, effective framework or schema applicable to 
monitoring the quality of care and utilization review 
in institutional settings. At the same time, 
administrators and researchers were taking more 
interest in the effect of patient mix on the then 
available data on the cost of institutional performance, 
and in the subsequent control for casemix in a variety 
of cross-institutional comparisons. 

To perform such analyses and comparisons, it was 
necessary to have a precise and uniform definition of 
what constitutes a "case" in an inpatient setting. Prior 
to the DRG scheme, and its related research, "case 
costs" were not defined precisely. However, changing 
needs necessitated a more precise definition. Although 
each patient admitted to an institution is unique, for 
purposes of analyzing hospital efficiency and 
effectiveness, a decision was made to group cases 
(patients) based on their demographic, diagnostic and 
therapeutic attributes. The similarities and differences 
discerned in terms of these attributes have a profound 
impact on determining treatment protocols during a 
patient's hospital stay, and consequently the level of 
resources consumed. 

"Resource consumption" then became the pivotal 
point on which the DRG system was built. Using 
such a system, which presupposes that certain patient 
characteristics can be considered common in terms of 
the use of diagnosis and treatment procedures, enables 
the administrator to analyze institutional effectiveness 
in terms of the patient "products" under care, as well 
as the resources a patient "consumes" and their 
"costs." 

While this sounds simple, one can immediately 
think of the myriad of ways such a system could 
become complex and perhaps overwhelming in its 
detail. We set out to develop a system that would be 
based on patterns of care which are "clinically 
coherent." The evolution of the DRG scheme was 
accomplished by collapsing diagnosis code into 23 
Major Diagnostic Categories, and then dividing each 
of these categories into subgroups by further 
breakdowns of diagnostic attributes and demographic 



characteristics. In turn, these attributes provided a 
way of explaining variations in length of stay and cost 
of care. 

In order to implement this complex system for 
analyzing medical information, a special interactive 
computer system (AUTOGRP) was created (Mills, et 
al., 1975). This system permits the clinical or 
administrative expertise of the user to be combined 
with sophisticated computer techniques, thus enabling 
rapid information processing, hypothesis testing, 
development of norms, and identification of aberrant 
cases. AUTOGRP is a powerful tool for 
understanding the process of patient care management 
and is widely applicable in a variety of institutional 
settings. 

AUTOGRP was developed as a mechanism for 
investigating relationships between the demographic 
and clinical characteristics of hospital inpatients and 
the consumption of resources. The AUTOGRP 
statistical analysis system enables the user to partition 
data into classes or groups of patients through a 
statistical algorithm. The algorithm employed is a 
modified version of the Automated Interaction 
Detector (AID) method (Sonquist and Morgan, 1964). 
Observations are grouped to maximize explained 
variance in the values of the dependent variable(s). 
For a description of the alogrithm used by 
AUTOGRP, refer to Case-Mix Definition by 
Diagnosis-Related Groups, (Fetter, et al., 1980). 
AUTOGRP is an extension of a general programming 
language referred to as Conversational Modeling 
Language (CML) (Autosel, 1978; Elia, et al., 1978; 
and Mills, et al., 1978). (A detailed description of 
commands can be found in the A UTOGRP Reference 
Manual (Theriault, et al., 1979).) 

This manual describes the most recent development 
of the DRG system. It offers a particular way of 
viewing resource consumption vis-a-vis diagnostic 
attributes. 

Rationale 

During the sixties and early seventies, researchers 
(Bayes, 1977; Feldstein, 1965; Fetter, et al., 1980; 
Lave, et al., 1971; Lee, et al., 1972; Lee, et al., 1973; 
Shin, 1977a; Shin 1977b; Thompson, et al., 1975) 
began to take an interest in "case-mix, and some 
proposed to define hospital output on this basis. In the 
sixties, several attempts to explain cost variation 
among hospitals were developed, each focusing on 
institutional characteristics, such as bed size, average 
length of stay, existence of residency program, 
proportion of board certified medical staff, provision 
of special services, and presence of medical school 
affiliation. 

The thrust of case-mix research in the seventies was 
directed at describing more precisely the attributes of 
these patients, and was far more sensitive to the 
complexity and variety of attributes within cases. The 
next step was to determine, for these patients, 
characteristics that describe case-mix, such as the 



3 



Figure 1.1 
Single Diagnosis Method 

Ulcer of the stomach Number of 

patients 
252 



Mean 
LOS 
10.4 



S.D. 
LOS 
6.5 



Alternative Approach 




No surgery 
Oscopies 

Esophagoscopy & gastroscopy 
Endoscopy of colon & rectum 
Cystoscopy & urethroscopy 

Otomies 

Exploratory laparotomy or celiotomy 
Gastric resection, partial or subtotal 
Vagotomy 



Number of 
Patients 
111 
105 



36 



Mean 
i OS 
6.8 
11.9 



S.D. 

LOS 
4.3 
5.9 



17.2 



6.7 



diagnoses of the patients' illnesses and the procedures 
performed. There is little doubt that delineation offers 
a better explanation of hospital resource consumption. 
One outcome of these studies was the departure from 
the more common and traditional measures of hospital 
output (patient days, and number of patients treated). 
This represents a significant philosophical shift that 
attempts to build on production functions, rather than 
on case functions without production data. 

Two principal methodologies have been used to 
approach the problem of case-mix definition. One 
approach, the Single Diagnosis Method, is a 
frequently applied definition of case-mix based on the 
patient's primary diagnosis. The primary diagnoses 
are recorded using some variant of the International 
Classification of Diseases. These schemes were 



intended to provide a classification of conditions of 
morbidity and mortality for statistical reporting 
purposes and information retrieval. Because this 
methodology is based on diagnoses alone, it is 
insufficient for defining cases by resource 
consumption. 

Additional variables such as procedures performed 
or age of patient, in conjunction with diagnosis, must 
be introduced to adequately describe sets of patients 
with similar utilization patterns in inpatient facilities. 
The use of additional variables are shown in Figure 
1.1, which compares the single diagnosis method with 
an approach that uses both the primary diagnosis and 
the types of secondary diagnoses that may be assigned 
for defining the hospital "product" definition of 
patient care. 



4 



Figure 1.2 

Pas Method for each of 349 diagnostic groups 



Single 
diagnosis? . 



No 



Yes 



Operated'' 



Operated? 




0-19 



20-34 



35-49 



50-64 



65 + 



Another widely used patient classification scheme 
was developed by the Professional Activity Study 
(PAS) of the Commission of Professional and Hospital 
Activities. It published tables of length-of-stay (LOS) 
statistics, gathered from participating hospitals. These 
tables were summarized on the basis of primary 
diagnosis, presence of any additional diagnoses, 
presence of any surgeries, and age. The PAS 
classification divided the diagnoses into 349 distinct 
groups. Within these groups, many of the diagnoses 
were homogeneous. When classification is done on 
operation, age(s), and secondary diagnosis, the result 
is almost 7,000 patient classes. (Figure 1.2 illustrates 
the PAS method.) The fundamental problem with the 
PAS method is that in cases where age is not 
important (for example, senile cataract), the method 
overspecifies the case type. In those cases where type 
of surgery is important (such as in diabetes, limb 
amputation vs. a retinal procedure), the method 
underspecifies the resource requirements. 

To describe case mix, what is necessary is a patient 
classification scheme that is manageable in terms of 
the number of case types defined, and is reasonable in 
describing variation in resources needed for treatment. 
DRGs were developed as an alternative patient 
classification scheme in response to the problems 
inherent in the PAS scheme, and the limited scope of 
the Single Diagnosis Method. The approach to patient 
classification greatly depends upon the situation in 



which the classes are being applied. The level of 
aggregation involves a trade-off between loss of 
specificity and ease of review of statistical summaries 
for comparative purposes. The classification of 
patients can be an extremely subjective process and is 
dependent upon the purpose the classification is to 
serve. 

Because diagnostic procedures are a key function of 
the patient's known or suspected condition, treatment 
modalities and services are generally prescribed on 
the basis of diagnosis. Likewise, the length of time a 
patient is hospitalized is linked to the diagnosis 
assigned by the physician. Given this, the purpose of 
the DRG classification is to account for the type and 
amount of hospital resources required to provide care. 
This presupposes that groups can be defined based on 
similar patterns of resource consumption for cases 
within each group. 

The research documented here represents the 
current stage of development of the DRGs and is a 
major departure from the 383 DRG scheme 
previously reported (Fetter, et al., 1980). The major 
objective of this research was to respond to the 
opportunity to reevaluate and redefine DRGs using 
the International Classification of Diseases, 9th Revision, 
Clinical Modification. The ICD-9-CM coding scheme 
was implemented in January 1979, replacing previous 
coding systems as the principal disease classification 
used in the United States. The decision to create a 



5 



clinical modification was based upon the need for 
increased specificity and a dual classification that 
provides codes according to etiology or manifestation. 

This refined classification takes into account a 
wider spectrum of diseases and disorders than 
heretofore, thereby facilitating the ability to 
differentiate a patient's diagnostic and therapeutic 
course of treatment. Since a mapping from ICD-9- 
CM to HICDA-2 (Commission on Professional and 
Hospital Activities, 1968) is available, abstracts coded 
in ICD-9-CM can be converted to HICDA-2 (with 
a loss in precision) and then grouped by using the 
HICDA-2 group definitions. 

Although the 383 earlier DRGs can still be used, 
they cannot be used in conjunction with the greater 
refinement in classification contained in ICD-9-CM. 
Therefore, changes in coding conventions necessitated 
the development of the new DRGs, tailored to the 
characteristics of ICD-9-CM. Even though the ICD- 
9-CM coding system is more specific than the ICDA- 
8 and the HICDA-2, it still does not allow for the 
level of precision desired by the clinicians who 



participated in development of the ICD-9-CM 
DRGs. 

DRGs are increasingly the center of discussion 
among regulators, hospital associations, third party 
payors, and academicians. Differences in the approach 
to case-mix definition involving the ICD-9-CM 
classification are not the result of only the greater 
refinement in classification provided by the ICD-9- 
CM system, but are related to changes in the basic 
logic used in the classification, some of which are in 
response to specific criticism of the earlier 
classification system. The differences result from: 
organizational and procedural changes; enlarged data 
base; and structural changes in the decisions that 
define DRGs. 

Over the past few years criticisms and 
misconceptions concerning the 383 DRGs have been 
raised. A further intent of this research was to address 
these issues. Table 1.1 describes many of these 
concerns involving the limitations of data base and 
variables used to describe and measure hospital case 
mix, and the lack of clinical homogeneity in some 
DRGs. 



Table 1.1 

Criticisms and misconceptions about the 383 version of DRGs 



Criticisms 



Response(s) 



DRGs rely on patient abstract information which is often not 
reliable. 

DRGs are not representative nationally. 

The DRGs reflect the state of medical practice at the time of their 
development. 

Length of stay is not an appropriate measure of hospital resource 
consumption. 

The DRGs are not statistically stable or reproducible with new data 
bases. 

Some DRGs contain patients which, from a medical perspective, 

are quite different. 
Some broad diagnostic areas such as acute myocardial infarction 

(AMI) are not subdivided into DRGs. 
The DRGs do not differentiate patients in different stages of the 

same illness. 

Patient age should have been used more often in the DRGs. 

Other variables such as socioeconomic status and type of admis- 
sion should have been included in the DRGs. 

Most DRGs contain too few cases for meaningful comparative 
analysis. 

A process variable (surgical procedure performed) is used in the 
definition of the DRGs. 



Use of abstract information will increase its accuracy. 

Level of aggregation reduces the effect of errors. 

Mainly New Jersey data was used to form these because the DRG 

research was at an early developmental phase. 
The DRGs need to be reevaluated periodically. However, DRGs 

can be used to identify changes in practice. 
Within a major diagnostic category, length of stay and cost are 

highly correlated. 

The same patterns of variation for the DRGs have been observed 

in other data sets 
Western Pennsylvania Study used a different grouping strategy. 
Tradeoff between the number of groups and clinical homogeneity. 
All patients must be grouped. 
Date did not substantiate. 

Lack of necessary data. 

Not medically substantiated. 
Secondary diagnoses correlated to age. 
Lack of necessary data. 

Statistical analysis can be used with small samples. 

Sufficient information is not available to predict the need and type 
of surgery. 



Organization of project 

Given the broad scope of the project, involvement 
was sought from a diversity of individuals and 
organizations. To carry out the project efficiently and 
effectively, three committees were established. The 
Yale Research Team was comprised of physicians, 
computer programmers, and health services research 
staff who provided the necessary medical, statistical, 
economic, and financing expertise. This blend of 
backgrounds was further enhanced by input from a 



multidisciplinary Steering Committee made up of 
physicians, statisticians, a medical records consultant, 
and health services researchers charged with the 
responsibility of overseeing the project. 

Under the terms of this grant, the Commission on 
Professional and Hospital Activities (CPHA) had a 
subcontract with Health Systems Management Group 
(HSMG) to provide an ICD-9-CM data base and to 
organize a physician task force consisting of 
participants from the original clinical task forces 
involved in the development of the ICD-9-CM 



6 



classification. The charge of this clinical group, 
referred to as the Clinical Council on Classification, 
was to review the clinical decisions made by Yale 
Project staff physicians and the physicians on the 
Steering Committee, with respect to the resulting 
structure of the DRGs. The Commissioner's Physician 
Advisory Committee and the Hospital Care 
Subcommittee of the New Jersey State Department of 
Health provided detailed comments to Yale Project 
Staff (see Appendix VIII). 

Enlarged data base 

The second difference between the ICD-9-CM 
DRGs and previous versions is the data base utilized 
in the grouping process. Earlier versions of the DRGs 
were limited because of the difficulty in assembling 
large, high quality data bases from a variety of acute- 
care, short-term hospitals. Also, length of stay was 
used as the dependent variable in earlier research 
since no cost data bases were available at the time. 
An assumption tested by the DRG research staff was 
that generally length of stay can be used as a 
surrogate for cost. There appeared to be a high 
correlation between the two measures — length of stay 
and cost (McClain, 1970). Therefore, in the 
development of the research protocol for this project, 
emphasis was placed on using a separate data base 
that included cost data. The cost data base was used 
to replicate the grouping strategy to test the 
hypothesis that for each Major Diagnostic Category 
(MDC), the same DRGs would result from change of 
dependent variable. (A definition of MDCs is 
contained in Section 3 and Appendix II. 

Clinical input 

Another difference compared to previous work was 
related to the relative importance of the statistical 
algorithm and the clinical judgments of the physician 
team. Previous iterations depended greatly on 
statistical recommendations for establishing decisions 
in the partitioning process. The automatic interaction 
detector (AID) algorithm was the statistical method 
used. Although this statistical approach was used in 
every step of DRG formation, clinical judgments 
were given a higher priority than previously. 

In many instances, the statistical results were used 
to test the clincial expectations of the physician team. 
As a consequence, more involvement of clinicians was 
required in the fourth iteration than in the previous 
versions. In a few cases, some of the statistical 
indications for partitioning were not accepted because 
they were not clinically supported. It is possible to 
develop purely statistical groups of patients that 
would explain a substantial amount of variation in 
length of stay and/or cost. This approach would 
probably result in less than 100 catagories being 
formed. However, from a clinical perspective, many 
of these classes would not make sense. For example, a 
group might consist of patients with cardiology, 
urology, ard orthopedic disorders. 

It was in the structure of the decision process that 



the greatest differences between the last and the new 
version occurred. The first such change was to 
resolve one of the major problems in the previous 
categorization; that is, the potential conflict in the 
basic coding system between the organ system 
involved in ICD-9-CM and in the etiology of the 
disease as coded. In defining MDCs the organ system 
approach was used because medical practice is 
primarily by specialty which is based on body system. 
As a consequence, most of the etiological 
organization of ICD-9-CM was reorganized into the 
organ system involved. (This concept is described in 
Section 3.) 

The second major structural difference was in the 
selection of complications and comorbidities. A 
complication is a condition other than principal 
diagnosis that occurs while a patient is in the hospital. 
Comorbidity represents a condition that existed before 
the patient was admitted to the hospital. Rather than 
categorizing patients on the basis of the presence of 
absence of any secondary diagnosis, or counting the 
numbers of such conditions, specific lists of 
"substantial" complications and comorbidities were 
developed based on the clinical judgment of the Yale 
team. (Substantial complications and comorbidities are 
defined in Section 2.) 

The third major structural difference was the 
manner that the initial split in each Major Diagnostic 
Category was made. This split was usually made on 
the presence or absence of an operating room 
procedure. An operating room procedure was defined 
as that which, based on clinical judgment, would in 
most hospitals be performed in the operating room. 
Those surgical procedures, such as simple biopsies 
and the like that would normally not be done in the 
operating room, would not be classified as "surgical." 
This again was a clinical decision based on the fact 
that this characteristic dictated the kind of physician 
that would be caring for the patient, and the kinds 
and types of resources such as operating rooms, 
recovery room use, and post-op intensive care, that 
would be devoted to the treatment of the patient 
during the hospital stay. Operating room procedures 
are listed in Section 2. There were MDCs where this 
split was not used, such as in psychiatric conditions 
and drug addiction. 

An additional new feature of the operating room 
procedure subroutine was the establishment of a 
surgical hierarchy. For each MDC, operating room 
procedures were ranked from the most to the least 
resource-intensive, based again on the clinical 
judgment of the physician team. The subroutine then 
loops through the entire list of procedures and selects 
the most resource-intensive procedure of those listed. 

A new variable "age70cc" was developed to 
include both the age factor and the presence of 
absence of selected complications or comorbidities. In 
general, the more resource-intensive class is identified 
by either age greater than or equal to 70, presence of 
complication or comorbidity, or both. Age was used 
for partitioning throughout the entire system. For 
purposes of consistency, a liberal definition for 
pediatrics was applied, "0.17." Also, the research 



419-177 0-84—2 



protocol incorporated a replication strategy for 
measuring agreement among different systems of 
classification. 

Deaths were included in the formation process, 
whereas in the earlier versions they were excluded. 

DRG characteristics 

In order that the definition of case types (DRGs) be 
easily implemented in a wide range of settings, as well 
as clinically coherent to medical and nonmedical 
users, it was important that the classification scheme 
have the following characteristics: 

• The scheme must be interpretable medically, with 
subclasses of patients from homogeneous diagnostic 
categories. That is, patient groups are expected to 
evoke a set of clinical responses that result in a 
similar pattern of resource use. When a patient class 
is described to a physician, he or she should be able 
to understand these patients and be able to identify 
a specific patient management process for them. 

• Classes of patients should be defined on variables 
normally collected, and commonly available on 
hospital abstracts. The Uniform Hospital Discharge 
Data Minimum Data Set format was used for 
purposes of defining and constructing the new 
DRGs. Since this data set contains relevant 
information to output utilization, pertaining to 
either the condition of the patient or the treatment. 

• There must be a manageable number of patient 
classes, preferably under five hundred groups that 
are mutually exclusive and exhaustive. These 
classes must cover the entire range of possible 
disease conditions in the inpatient setting without 
overlap. 

• An upward compatability with Medicare Provider 
Analysis and Review (MEDPAR) data sets must be 



maintained. MEDPAR provides a limited number 
of data elements that can be used to describe case 
mix. 

• Each group must have a statistically stable 
distribution of length of stay and cost. 

• Guidelines will be used in the formation of the new 
DRGs. (Described in Section 2.) 

• Because one of the major uses of the DRGs would 
be as a basis for comparative analysis at an 
individual hospital level, it was desirable to have 
the expected number of patients in a DRG to be of 
sufficient size. Exceptions to this rule were in the 
case of infrequent classes of patients who required 
resources that were typically only done in highly 
specialized hospitals. Clinical judgment was used to 
select these infrequent DRGs. 

• The entire range of patients seen in an inpatient 
setting must be accounted for in the patient 
classification scheme. 

Purpose of final report 

The purpose of this final report is to describe the 
new ICD-9-CM Diagnosis-Related Group 
Classification Scheme. 

The methodology, construction of the diagnosis- 
related groups, and the replication substudy are 
discussed, as well as future implications and 
limitations. 

One section, "Identification of Outliers and 
Descriptive Statistics," containing 900 pages, is not 
included in this report. Additionally, a five-volume 
series is available from the Health Systems 
Management Group. Inquiries on either should be 
addressed to Ann T. Freedman, Project Director, 
Health Systems Management Group, P.O. Box 1A, 
New Haven, Conn. 06520. 



8 



Section 2: Methodology 
Data base 

Patient data used to form groups of patients were 
obtained from the Commission on Professional and 
Hospital Activities (CPHA), Professional Activity 
Study (PAS) and the New jersey State Department 
of Health, New Jersey Cost Per Case Research 
Microdata File. Appendix IX contains the record 
layouts of all data sets used in this project. The 
primary data set was from CPHA. This national data 
base was gathered from PAS short-term hospitals that 
demonstrated accurate and timely data for the third 
and fourth quarters of 1979. The data for the first 6 
months of 1979 were not used in order to reduce 
problems of reliability and validity resulting from the 
conversion from H-ICDA-2 and ICD-8 to ICD-9- 
CM. Hospital selection focused on keeping the same 
proportion of PAS hospitals in each class of hospitals 
as would be found in the universe of all hospitals in 
the United States. CPHA used the American Hospital 
Association's Annual Survey of Hospitals 
Questionnarie to select a universe that would be 
nationally representative for this study. (The count 
for each stratum for the nation, and the CPHA data 
base are shown in Tables 2. 1 and 2.2, respectively.) 

To achieve proportional representation, the 
following criteria were observed: 

• In cells that overrepresented the universe, a 
proportional group of PAS hospitals were selected 
from those having the best reputations for timely 
and accurate submission of data. 

• In cells that needed five or fewer hospitals to 
obtain the correct proportions, every effort was 
made to provide a minimum of five hospitals to 
ensure both confidentiality and adequate 
representation by strata. 

A quota sample was drawn resulting in the 
selection of 332 hospitals from the 2,100 institutions 
participating in PAS. The resulting file contained 1.4 
million discharge records. Sampling strata were: 

• The nation was divided into four geographic 
regions — Northeast, North Central, South, and 
West — shown in Figure 2.1. 

• Standard Metropolitan Statistical Area (SMSA) was 
categorized as none or unknown; greater than one 
million population; or less than one million 
population. 

• Bed Size was divided into three categories: less 
than 100 beds, 100 to 399 beds, or greater than or 
equal to 400 beds. 

• Teaching status of a hospital was described as 
minor, major, and non-teaching. Minor teaching 
had at least one approved residency in internal 
medicine, obstetrics and gynecology, pediatrics, or 
surgery. Major teaching hospital had an approved 
residency in at least three of the four specialties 
described under minor teaching. Nonteaching had 



no approved residencies in any of the specialties 

described under minor teaching. 

While this sample is nationally representative, self- 
selection bias is a possibility because only PAS 
participating hospitals were represented. 

The New Jersey State Department of Health data 
set contained 334,924 patient records from 33 
hospitals. New Jersey's data base supplied additional 
cost information unavailable from CPHA. This 
allowed for the use of total direct cost of treating a 
patient as the dependent variable. 

The sampling plan used for selecting a subset of the 
1.4 million records from the CPHA data set for DRG 
formation is described in the subsequent section.* It is 
anticipated that the number of clusters (DRGs) is 
correlated with the variance of LOS. That is, within a 
Major Diagnostic Category, the higher the variability 
in LOS the more clusters of DRGs. 

It was not feasible, in terms of budgetary and 
system constraints, to analyze interactively 100 
percent of the records from CPHA's data base. A 
sample of size 250,000 was considered manageable in 
light of projected cost estimates based on preliminary 
analyses. 

We chose to stratify on MDC and select a simple 
random sample within each MDC as opposed to a 
simple random sample of all records for the following 
reason: As previously noted, for medical 
interpretability the data were initially divided into 23 
Major Diagnostic Categories that were to be 
partitioned further on the basis of other independent 
variables.Therefore, we wanted to be sure we 
obtained sufficient numbers of records in each MDC 
in order to perform the analysis. 

There are many ways to allocate the 250,000 
records among the individual strata or MDCs. The 
best allocation is a function of: the MDC size, the 
variability in length of stay within each MDC, and 
the cost of obtaining an observation from each MDC. 
The allocation that minimizes cost for a fixed level of 
precision or maximizes precision for a fixed cost is 
referred to as Neyman allocation. 



* Both the rationale and plan are based on discussions with 
Daniel Freeman, Associate Professor, Department of Epidemiology 
and Public Health, Yale University School of Medicine. 



9 



Table 2.1 

Universe of hospitals for the United States 





None/unknown SMSA 


< 1 million SMSA 


> 1 million SMSA 




Non- Minor Major 
teaching teaching teaching 


Non- Minor Major 
teaching teaching teaching 


Non- Minor Major 
teaching teaching teaching 


<100 beds 


2,257 3 


593 7 1 


520 2 2 


100-399 beds 

400+ beds 


919 13 7 
113 2 6 


799 76 43 
216 75 98 


846 120 62 
149 93 165 



Total hospitals: 7,187. 

SOURCE: Commission on Professional and Hospital Activities, "Selection of Hospitals for DRG Project Yale University," Memorandum Report, September 
1 980, Prepared by Linda Snoddon. 

Table 2.2 
Universe of CPHA study hospitals 





None/unknown SMSA 


<1 million SMSA 


>1 million SMSA 




Non- Minor Major 


Non- Minor Major 


Non- Minor Major 




teaching teaching teaching 


teaching teaching teaching 


teaching teaching teaching 


< 1 00 beds 


73 


20 1 


20 


100-399 beds 


40 1 


48 12 6 


40 13 7 


400+ beds 


3 


10 9 5 


6 8 10 



Total hospitals: 332. 

SOURCE: Commission on Professional and Hospital Activities, "Selection of Hospitals for DRG Project Yale University," Memorandum Report November 
1981, Prepared by Linda Snoddon. 



Figure 2.1 

Geographic regions in the United States 



Northeast 




SOURCE: Length of Stay in PAS Hospitals, by Diagnosis, United States, Northeastern Region, 1976 CPHA Commission on Professional and Hospital Activities, 
Ann Arbor, Michigan, October 1977. 



10 



Table 2.3 

Subsamples drawn for Major Diagnostic Categories 





Major diagnostic category 


i oiai 
observations 


Sample 
size* 


Sample 


01 


Diseases and Disorders of the Nervous System 


79,184 


26,392 


33.33 


02 


Diseases and Disorders of the Eye 


28,772 


9,589 


33.33 


03 


Diseases and Disorders of the Ear, Nose and Throat 


64,375 


21,456 


33.33 


04 


Diseases and Disorders of the Respiratory System 


85,288 


28,145 


33.00 


05 


Diseases and Disorders of the Circulatory System 


146,958 


44,342 


30.17 


06 


Diseases and Disorders of the Digestive System 


170,204 


25,914 


15.23 


07 


Diseases and Disorders of Hepatobiliary System and Pancreas 


38,764 


9,086 


23.44 


08 


Diseases and Disorders of the Musculoskeletal Systme and Connective Tissue 


153,722 


51,235 


33.33 


09 


Diseases and Disorders of the Skin, Subcutaneous Tissue and Breast 


57,211 


10,336 


18.07 


10 


Endocrine, Nutritional and Metabolic Diseases and Disorders 


31,921 


7,910 


24.78 


11 


Diseases and Disorders of the Kidney and Urinary Tract 


55,460 


9,666 


17.43 


12 


Diseases and Disorders of the Male Reproductive System 


25,263 


4,564 


18.07 


13 


Diseases and Disorders of the Female Reproductive System 


87,056 


5,879 


6.75 


14 


Pregnancy, Childbirth and Puerperium 


177,043 


59,008 


33.33 


15 


Newborns and Other Neonates with Conditions in the Perinatal Period 


141,642 


47,209 


33.33 


16 


Diseases and Disorders of the Blood-Forming Organs and Immunological Disorders 


11,504 


2,291 


19.92 


17 


Myeloproliferative Diseases and Disorders and Poorly Differentiated Neoplasms 


16,823 


5,552 


33.00 


18 


Infectious and Parasitic Diseases (Systemic or Unspecified Sites) 


11,681 


2,374 


20.32 


19 


Mental Diseases and Disorders 


33,035 


10,902 


33.00 


20 


Substance Use and Substance Induced Organic Mental Disorders 


14,503 


4,786 


33.00 


21 


Injuries, Poisonings and Toxic Effects of Drugs 


22,321 


6,245 


27.33 


22 


Burns 


530 


145 


27.33 


23 


Factors Influencing Health Status and Other Contacts with Health Services 


5,419 


1,788 


33.00 




Total 


1,458,679 


394,814 





'Values expressed have been rounded off. 



Sub-sampling plan 

Using the Neyman allocation process, the sample 
size in each MDC (nj ) was computed by: 



n = n 



N, 



■cr-Vq 



23 
k=l 



where n = the total sample size (in this case 250,000), 
Nj= the number of records in the i'th MDC, 
Ci= the cost of obtaining an observation from the 
i'th MDC, 

oV= the population variance (of LOS) in the i'th 
MDC. 

Since the cost of obtaining a record is the same 
across MDCs, we let 

Ci=C2= . . . C23 and the formula reduces to: 



n, = n 



23 



NjO-j ^ N k o- k 



k=l 



The population variance can be estimated from a 
sample of records from each MDC. Therefore, in 
order to determine the sample sizes under Neyman 
allocation, we generated the following statistics 
within each MDC: 

(1) Nj= the number of records in each MDC, 

(2) Sj= an estimate of the population variance (in 
LOS) in each MDC, 

(3) Xj= an estimate of the mean LOS in each 
MDC. 

Table 2.3 summarizes the sample sizes based on the 
allocation formula after eliminating observations at 
the 98th percentile for each MDC. A total sample size 
of 394,814 observations was used. 

In four MDCs — 02 Eye, 03 Ear, Nose, and Throat, 
14 Pregnancy, Childirth, and Puerperium, and 15 
Newborn — the category is dominated by a single 
patient type. In 02, it is lens extraction, in 03 it is 
T&A, in 14 it is delivery, and in 15 it is normal 
newborn. The dominance of one class made it 
necessary to redefine the sample size in these cases in 
order to allow detection of groups from the remaining 
data at the same level of precision as in other MDCs. 
Thus, we recalculated the required sample size in 
these MDCs after removal of the dominant group. 
Essentially, the sample size was increased to the 
projected size shown in Table 2.3 after removal of 
that group. 



11 



Table 2.4 

Uniform hospital discharge data set elements 



Data element Definition 



Personal identification A unique number assigned to each patient usually at the time of 

admission to the hospital. 

Date of birth Month, day, and year 

Sex Male; Female 

Race and ethnicity American Indian or Alaskan Native; Asian or Pacific Islander; Black; 

Hispanic; White; and Other. 
Residence Zip code 

Hospital identification A unique, hospital number within a data collection system. 

Admission and discharge date Month, day, and year 

Physician identification attending He or she is the physician primarily responsible for the patient's 

care from the beginning of the hospital episode. 

Operating He or she is the operating physician who performed the principal 

procedure. 

Principal diagnosis The final diagnosis which best explains why the patient was ad- 

mitted to the hospital. 

Other diagnoses (maximum of five diagnoses including the principal All diagnoses referring to conditions that are present upon admis- 
should be abstracted). sion, that develop during the given episode of care, or that 

impact the treatment received and/or the length of stay. Ex- 
cluded are diagnoses that relate to a previous episode of care, 
which have no impact on the current hospitalization. 

Procedures and dates Significant procedure(s) carries an operative or anesthetic risk, 

requires highly-trained personnel or requires special equipment 
and are to be reported. 

Disposition of patient Discharged to home; left against medical advice; discharged to 

another short term hospital; discharged to a long-term care 
institution and died. 

Expected principal source of payment Self-pay; workmen's compensation, Medicare, Medicaid; maternal 

and child health; other government payments, blue cross, insur- 
ance companies; no charge; and other. 



SOURCE: Uniform Hospital Discharge Data Minimum Data Set, Report to the National Committee on Vital and Health Statistics, 1980 



The remaining data after extracting the grouping 
samples was used to verify the statistics of the groups 
defined from these samples. A MEDPAR data base 
was provided by the Health Care Financing 
Administration (HCFA), Department of Health and 
Human Services. A complete description of this data 
base along with the MEDPAR version of diagnosis- 
related groups is described in Appendix III. 

Variables used in the construction of DRGs 

The patient attributes or variables that are used to 
define patient classes should be limited to information 
that is readily available and routinely collected. By 
restricting the patient characteristics to variables 
readily available, the patient classification scheme can 
be extensively applied. Therefore, in developing the 
new ICD-9-CM DRG classification scheme only 
uniform hospital discharge data set (UHDDS) 
elements were used in the final grouping process. 
UHDDS is a minimum set of hospital data, comprised 
of 14 items summarized in Table 2.4. Appendix X 
provides a summary of "Uniform Hospital Discharge 
Data Set Final Summary Report of Activities, 1975- 
1978 U.S. National Committee on Vital and Health 
Statistics." Other data elements were analyzed to 



explore the interrelationships of these variables and to 
determine the ones that were related to the dependent 
variable. 

Patient records from CPHA and New Jersey data 
bases contained demographic, clinical, and diagnostic 
information related to LOS. Specific data elements 
are summarized in Table 2.5. Diagnostic and 
procedure information in these data bases was coded 
in ICD-9-CM. Additional variables that were created 
specifically for use in this project are described in 
Table 2.6 and Table 2.21. Of particular importance 
are operating room procedure, substantial 
comorbidity and/or complication and age >70 and/ 
or substantial comorbidity and/or complication. 

Surgical information on the patient's abstract are 
often ordered according to the date the procedure 
occurred. In addition, many minor procedures are 
coded along with more major surgical procedures. 
The ICD-9-CM, Volume 3 Procedures Tabular List 
and Alphabetic Index covers not only procedures 
performed in an operating room, but also some 
therapies and minor diagnostic procedures. To 
effectively deal with the surgical information 
provided, each valid ICD-9-CM procedure code was 
classified as operating room or non-operating room 
based on clinical judgment. Each code was evaluated 



12 



Table 2.5 
Data base elements 



Data sets 

Variable name 



CPHA NJ UHDDS 



Personal identification 

Medical record number 

Date of Birth 

Month 

Day 

Year 

Sex 

Male 

Female 

Race/Ethnicity 

American Indian, Alaskan Native 

Asian, Pacific Islander 

Black 

Hispanic 

White 

Other 

Residence 

Zip code 

Hospital identification 

Admission and discharge date 

Month 

Day 

Year 

Attending physician identification 

Operating physician identification 

Diagnoses 

Principal 

Other 

Procedures (all Class 1-3 required) 

Principal , 

Other 

Procedure dates 

Month 

Day 

Year 

Disposition of patient 

Discharge home 

Left against medical advice 

Discharge short-term hospital 

Discharge long-term care institution. 

Died 

Expected principal payment source 

Self pay 

Workmen's compensation 

Medicare 

Medicaid 

Maternal and child health 

Other government payments 

Blue Cross 

Insurance companies 

No charge 

Other 



(1) 


* 


* 


* 


(6) 


(7) 


(4) 


(6) 


* 
* 


* 
* 


* 

* 


* 

(10) 



( ) The number within the parentheses is the number of diagnoses and or the number of procedures documented in the data base. 



13 



Table 2.5— Continued 
Data base elements 



Additional variables (non-UHDDS) 



CPHA 



Data sets 



NJ 



HSMG 
Yale 



Admission hour 

Length of stay 

Age 

Secondary payment sources 

Admission diagnosis 

Added discharge status 

Home health services * 

Rehabilitation center 

Other 

Added/Died variables 

Autopsy 

In operating room 

Post-op 

Coroner's case 

Locality code 

Admission status 

Hospital service 

Admission to intensive care unit 

Admission to coronary care unit 

Admission to special care unit 

Birth weight with indicator 

Hospital type 

Quarter of admission and discharge 

Day of week of admission and discharge . 

Added age in days and months 

Referral source 

Added special care units 

Days in unit 

Preoperative LOS 

Consultation service 

Major diagnosis 

Major procedure 

Old DRG number 

PSRO 

Cost 



SOURCES: Commission on Professional and Hospital Activities, Professional Activity Study Abstract, Record Description 1 979, Prepared by Linda Snodden; 
Uniform Hospital Discharge Data Minimum Data Set, Report to the National Committee on Vital and Health Statistics, 1980; New Jersey Cost Per Case ("Y- 
Tape") Research Microdata File Description, New Jersey State Department of Health, 1 979. 



to determine if, when performed on an inpatient, that 
procedure would generally be performed in an 
operating room. (Operating room procedures are 
listed in Table 2.7.) 

Instead of categorizing patients based upon the 
presence or absence of any secondary diagnosis or 
counting the numbers of such conditions, specific lists 
of "substantial" complications and comorbidities were 



developed based on the clinical judgment of the Yale 
physician team. A complication is a condition other 
than the principal diagnosis that occurs after the onset 
of the principal condition, usually after admission to 
the hospital. Comorbidity represents an underlying 
condition that existed before the patient was admitted 
to the hospital. Substantial complications and 
comorbidities were defined as those conditions that 



14 



Table 2.6 

Additional variables explored or used in the formation of DRGs 



Variable 



Definition 



Etiology . 



Number of ... . 

Secondary diagnoses 



Includes ranges of diagnosis codes: 

Infectious and parasitic diseases— 001 .-1 39.8. 
Endocrine, nutritional, and metabolic 
Diseases and immunity disorders— 240.-279.9. 
Malignant neoplasm— 140.-208.9, 230.-236.9, 238.4-238.7. 
Benign neoplasm— 210.-222.9, 237.-238.3, 238.8-239.9. 
Injuries— 800.-959.9, 980.-999.9. 

Poisonings by drugs, medicinal and biological substances— 960.-979.9. 
Pregnancy— 630.-676.9. 
Perinatal— 760-799.9. 

Idiopathic and others — all other remaining ICD-9-CM codes. 

Counts the number. . . 
on the patient abstract. 



Any diagnosis other than the principal diagnosis. 



Substantial Comorbidities 
Substantial complications 
Major diagnostic 
Categories involved 
Diagnostic procedures 
Presence or absence of . . . 
Secondary diagnoses 
Substantial comorbidities 
Substantial complications 
Operating room procedure 
Therapeutic operating room procedure 

Operating room procedure ranking Operating room procedure ranking is determined by the type of procedure and 

the difficulty. 
Difficulty of procedure(s) refers to: 

— procedure(s) is (are) performed in an operating room and is invasive; 
— procedure(s) is {are) not done in an operating room but is invasive; 
— procedure(s) is (are) not done in an operating room and is noninvasive; 
Type of procedure refers to: 
—diagnostic 
—therapeutic; 

—both diagnostic and therapeutic. 

Chemotherapy Includes diagnosis codes: 

V58.1— Maintenance chemotherapy and 

992.5 — Injection or infusion of cancer chemotherapeutic substance, NEC. 

Radiotherapy Includes diagnosis codes: 

V58.0— Radiotherapy and 

922.0- 922.9 — Therapeutic radiology and nuclear medicine. 
Physical therapy Includes diagnosis codes: 

V57.1— Physical therapy and 

930.1- 930.9— Physical therapy, diagnostic. 

931.0- 931.9— Physical therapy, exercises. 

932.1- 932.9— Physical therapy, musculoskeletal manipulation. 
933.1-933.9— Physical therapy, therapeutic procedures. 

Dialysis Includes diagnosis codes: 

V56.0-V56.8— Aftercare involving intermittent dialysis and 
399.5— Hemodialysis. 

Orthopedics Includes diagnosis codes: 

V540-V54.9 — Other orthopedic aftercare; 

V674— Followup examination following treatment of a fracture. 
Complications of procedures Includes diagnosis codes: 

998.0-998.9— Other complications of procedures not elsewhere classified. 
Urinary tract infection Includes diagnosis code: 

599.0— Urinary tract infection, site not specified. 



15 



Table 2.6— Continued 
Additional variables explored or used in the formation of DRGs 



Variable 



Definition 



Pneumonia Includes diagnosis codes: 

481 — Pneumococcal pneumonia. 

482.0-482.4— Other bacterial. 

482.8-482.9— Pneumonia. 

483 — Pneumonia due to other specified organism. 

484.1, 484.3, 484.5-484.8 — Pneumonia in infectious diseases classified else- 
where. 

485 — Bronchopneumonia, organism unspecified. 

486 — Pneumonia, organism unspecified. 
Heart Includes diagnosis codes: 

410.0-410.9— Acute myocardial infarction. 

415.11, 451.19 — Phlebitis and thrombophlebitis of deep vessels of lower 
extremities. 

451.81— Phlebitis and thrombophlebitis iliac vein. 
997.2— Peripheral vascular complications. 
Malnutrition Includes diagnosis codes: 

261 — Nutrition marasmus. 

262 — Other severe protein-calorie malnutrition. 

263.0-263.2, 263.8, 263.9— Other and unspecified protein-calorie malnutri- 
tion. 

Diabetes Includes diagnosis codes: 

250.00-250.91— Diabetes mellitus. 
Anemia Includes diagnosis codes: 

280.0-280.1, 280.8-280.9— Iron deficiency anemias. 

281.0-281.4, 281.8-281.9— Other deficiency anemias. 

282.0-282.5, 282.60-282.63, 282.69, 282.7-282.9— Hereditary hemolytic an- 
emias. 

283.0-283.2, 283.9— Acquired hemolytic anemias. 
285.0-285.1, 285.8-285.9— Anemia, unspecified. 

Cerebrovascular accident Includes diagnosis codes: 

431 — Intracerebral hemorrhage. 

432.0-432.1, 432.9— Other and unspecified intracranial hemorrhage. 
433.0-433.3, 433.8-433.9— Occlusion and stenosis of precerebral arteries. 
434.0-434.1, 434.9 — Occlusion of cerebral arteries. 
436.0— Acute, but ill-defined, cerebrovascular disease. 
Chronic obstructive pulmonary disease Includes diagnosis codes: 

491 .2 — Obstructive chronic bronchitis. 

492.0- 492.8— Emphysema. 
Paralytic ileus Includes diagnosis code: 

560.1— Paralytic ileus. 

Gastrointestinal hemorrhage Includes diagnosis codes: 

578.0, 578.9-578.1— Gastrointestinal hemorrhage. 

Chronic liver disease Includes diagnosis codes: 

571.0 — Alcoholic fatty liver. 

572.0-572.4, 572.8 — Liver abscess and sequelae of chronic liver disease. 
573.0-573.4, 573.8-573.9— Other disorders of liver. 

575.0- 575.6, 575.8-575.9— Other disorders of gallbladder. 
Puerperium complications Includes diagnosis codes: 

670 — Major puerperal infection. 

672 — Pyrexia of unknown origin during the puerperium. 

671 .3 — Deep phlebothrombosis, antepartum. 

671 .4 — Deep phlebothrombosis, postpartum. 

674.1- 674-3 — Other and unspecified complications of the puerperium, not 
elsewhere classified. 

Breast disorders Includes diagnosis codes: 

610.0-610.4, 610.8-610.9— Benign mammary dysplasias. 
611.72— Lump of mass in breast. 



16 



Table 2.6— Continued 
Additional variables explored or used in the formation of DRGs 



Variable 



Definition 



Fractured hip Includes diagnosis codes: 

820.00-820.03, 820.09— Transcervical fracture, closed. 
820.10-820.13, 820.19— Transcervical fracture, open. 
820.20-820.22— Pertrochanteric fracture, closed. 
820.30-820.32— Pertrochanteric fracture, open. 

8208 — Unspecified part of neck of femur, closed. 

8209— Unspecified part of neck of femur, open. 
821.00-821.01— Shaft or unspecified part, closed. 
821.10-821.111— Shaft or unspecified part, open. 

Neonatal jaundice Includes diagnosis codes: 

773.0-773.5— Hemolytic disease of fetus or newborn, due to isoimmunization 
774.0-774.2— Other perinatal jaundice. 

774.30-774.31, 774.39— Neonatal jaundice due to delayed conjugation from 
other causes. 

774.4— Perinatal jaundice due to hepatocellular damage. 

774.5 — Perinatal jaundice from other causes. 

774.6 — Unspecified fetal and neonatal jaundice. 

774.7— Kernicterus not due to isoimmunization. 
Adverse drug reaction Includes diagnosis codes: 

535.4— Other specified gastritis. 
693.0— Due to drugs and medicines. 
708.0 — Allergic urticaria. 

995.2 — Unspecified adverse effect of drug, medicinal and biological sub- 
stance. 

995.3— Allergy unspecified. 
Delirium tremens Includes diagnosis codes: 

291.0 — Alcohol withdrawal delirium. 

291 .3— Alcohol withdrawal hallucinosis. 
Alcohol dependence Includes diagnosis codes: 

303.00-303.03, 303.90-303.93— Alcohol dependence syndrome. 
Drug dependence Includes diagnosis codes: 

304.00-304.03, 304.10-304.13, 304.20-304.23, 304.30-304.33, 304.40- 
304.43, 304.50-304.53, 304.60-304.63, 304.70-304.73, 304.80-304.83, 
304.90-304.93— Drug dependence. 
Decubitus ulcer Includes diagnosis code: 

7070— Decubitus ulcer. 

Substantial comorbidity A pre-existing condition that will, because of their presence with a specific 

principal diagnosis, cause an increase in the length of stay by at least one day 
in approximately 75 percent of the cases. 

Substantial complication A condition that arises during the hospital stay that prolongs the length of stay by 

at least one day in approximately 75 percent of the cases. 

Age > 70CC Age<, no CC. 

Age> =, no CC. 
Age<, CC. 
Age> = , CC. 



17 



Table 2.7 

ICD-9-CM operating room procedure codes 



0112 CEREBRAL MENINGES BX NEC 

0114 OTHER BRAIN BIOPSY 

0115 SKULL BIOPSY 

0118 OTHER BRAIN DX PROCEDURE 

0119 OTHER SKULL DX PROCEDURE 

0121 CRANIAL SINUS I D 

0122 REMOV INTRACRAN STIMULAT 

0123 REOPEN CRANIOTOMY SITE 

0124 OTHER CRANIOTOMY 

0125 OTHER CRANIECTOMY 

0131 INCISE CEREBRAL MENINGES 

0132 LOBOTOMY TRACTOTOMY 
0139 OTHER BRAIN INCISION 

0141 THALAMUS OPERATIONS 

0142 GLOBUS PALLIDUS OPS 

0151 EX CEREB MENINGEAL LES 

0152 HEMISPHERECTOMY 

0153 BRAIN LOBECTOMY 
0159 OTHER BRAIN EXCISION 
016 EXCISE SKULL LESION 

0201 LINEAR CRANIECTOMY 

0202 ELEVATE SKULL FX FRAGMNT 

0203 SKULL FLAP FORMATION 

0204 BONE GRAFT TO SKULL 

0205 SKULL PLATE INSERTION 

0206 CRANIAL OSTEOPLASTY NEC 

0207 SKULL PLATE REMOVAL 

0211 SIMPLE SUTURE OF DURA 

0212 BRAIN MENINGE REPAIR NEC 

0213 MENINGE VESSEL LIGATION 

0214 CHOROID PLEXECTOMY 
022 VENTRICULOSTOMY 

0231 VENTRICL SHUNT -HEAD/NECK 

0232 VENTRI SHUNT-CIRCULA SYS 

0233 VENTRICL SHUNT-THORAX 

0234 VENTRICL SHUNT-ABDOMEN 

0235 VENTRI SHUNT- UN INARY SYS 
0239 OTHER VENTRICULAR SHUNT 

0242 REPLACE VENTRICLE SHUNT 

0243 REMOVE VENTRICLE SHUNT 

0291 LYSIS CORTICAL ADHESION 

0292 BRAIN REPAIR 

0293 IMPLANT BRAIN STIMULATOR 

0294 INSERT/REPLAC SKULL TONG 
0299 SKULL BRAIN OP NEC 

0301 REMOVAL FB SPINAL CANAL 

0302 REOPEN LAMINECTOMY SITE 
0309 SPINAL CANAL EXPLOR NEC 
031 INTRASPIN NERVE ROOT DIV 
0321 PERCUTANEOUS CHORDOTOMY 
0329 OTHER CHORDOTOMY 

0332 SPINAL CORD/MENINGES BX 

0339 OTHER SPINAL DX PROC 

034 EXCIS SPINAL CORD LESION 



0351 SPINE MENINGOCELE REPAIR 

0352 MYELOMENINGOCEL REPAIR 

0353 VERTEBRAL FX REPAIR 
0359 SPINAL STRUCT REPAIR NEC 
036 SPINAL CORD ADHESIOLYSIS 

0371 SUBARACH-PERITON SHUNT 

0372 SUBARACH -URETERAL SHUNT 
0379 OTH SPINAL THECAL SHUNT 

0393 INSERT SPINAL STIMULATOR 

0394 REMOVE SPINAL STIMULATOR 
039 7 REVISE SPINE THECA SHUNT 

0398 REMOVE SPINE THECA SHUNT 

0399 SPINE CANAL STRUC OP NEC 

0401 ACOUSTIC NEUROTOMY 

0402 TRIGEMINAL NERV DIVISION 

0403 PERIPH NERVE DIV NEC 

0404 PERIPH NERVE INCIS NEC 

0405 GASSERIAN GANGLIONECTOMY 

0406 PERIPH GANGLIONECT NEC 

0407 PERIPH NERV EXCISION NEC 
0412 PERIPH NERVE BIOPSY NEC 
0419 PERIPH NERVE DX PROC NEC 
043 PERIPHERAL NERVE SUTURE 

0441 DECOMPRESS TRIGEM ROOT 

0442 CRAN NERV ROOT DECOM NEC 

0443 CARPAL TUNNEL RELEASE 

0444 TARSAL TUNNEL RELEASE 
0449 PER NERVE ADHESIOLYS NEC 

045 PERIPHERAL NERVE GRAFT 

046 PERIPH NERVE TRANSPOSIT 

0471 HYPOGLOSS -FACIAL ANASTOM 

0472 ACCESSORY-FACIAL ANASTOM 

047 3 ACCESS -HYPOGLOSS ANASTOM 

0474 PERIPH NERV ANASTOM NEC 

0475 POSTOP REVIS PER NERV OP 

0476 LATE REPAIR PER NERV INJ 
0479 OTHER NEUROPLASTY 

0491 NEURECTASIS 

0492 IMPLANT PERIPH STIMULAT 

0493 REMOVE PERIPH STIMULATOR 
0499 PERIPHERAL NERVE OPS NEC 
050 SYMPATH NERVE DIVISION 
0511 SYMPATHETIC NERVE BIOPSY 
0519 SYMPATH NRV DX PROC NEC 

0521 SPHENOPALATIN GANGLIONEC 

0522 CERVICAL SYMPATHECTOMY 

0523 LUMBAR SYMPATHECTOMY 

0524 PRESACRAL SYMPATHECTOMY 
0529 OTHER SYMPATHECTOMY 
0581 SYMPATHETIC NERVE REPAIR 
0589 SYMPATHETIC NERVE OP NEC 
059 OTHER NERVOUS SYSTEM OPS 
0602 REOPEN THYROID FIELD WND 
0609 INCIS THYROID FIELD NEC 



18 



Table 2.7— Continued 
ICD-9-CM operating room procedure codes 



0612 OTHER THYROID BIOPSY 

0613 PARATHYROID BIOPSY 

0619 THYR/PARATHY DX PROC NEC 

062 UNILAT THYROID LOBECTOMY 

0631 EXCISION THYROID LESION 

0639 PART THYROIDECTOMY NEC 

064 COMPLETE THYROIDECTOMY 

0650 SUBSTERN THYROIDECT NOS 

0651 PART SUBSTERN THYROIDECT 

0652 TOT SUBSTERN THYROIDECT 

066 LINGUAL THYROID EXCISION 

067 THYROGLOSS DUCT EXCISION 
0681 TOTAL PARATHYROIDECTOMY 
0689 OTHER PARATHYROIDECTOMY 

0691 THYROID ISTHMUS DIVISION 

0692 THYROID VESSEL LIGATION 

0693 THYROID SUTURE 

0694 THYROID REIMPLANTATION 

0695 PARATHYROID RE IMPLANT 

0698 OTHER THYROID OPERATIONS 

0699 OTHER PARATHYROID OPS 

0700 ADRENAL EXPLORATION NOS 

0701 UNILAT ADRENAL EXPLORAT 

0702 BILAT ADRENAL EXPLORAT 

0712 OTHER ADRENAL BIOPSY 

0713 TRANSFRONT PITUITARY BX 

0714 TRANSPHEN PITUITARY BX 

0715 PITUITARY BIOPSY NOS 

0716 THYMUS BIOPSY 

0717 PINEAL BIOPSY 

0719 ENDOCRINE DX PROC NEC 

0721 ADRENAL LESION EXCISION 

0722 UNILATERAL ADRENALECTOMY 
0729 PART ADRENALECTOMY NEC 
073 BILATERAL ADRENALECTOMY 

0741 ADRENAL INCISION 

0742 ADRENAL NERVE DIVISION 

0743 ADRENAL VESSEL LIGATION 

0744 ADRENAL REPAIR 

0745 ADRENAL REIMPLANTATION 
0749 ADRENAL OPERATION NEC 

0751 PINEAL FIELD EXPLORATION 

0752 PINEAL GLAND INCISION 

0753 PARTIAL PINEALECTOMY 

0754 TOTAL PINEALECTOMY 
0759 PINEAL OPERATION NEC 

0761 EXC PITUIT LES-TRANSFRON 

0762 EXC PITUIT LES-TRANSPHEN 

0763 PART EXC IS PITUITARY NOS 

0764 TOT EXC PITUIT -TRANSFRON 

0765 TOT EXC PITUIT -TRANSPHEN 

0768 TOTAL EXC PITUITARY NEC 

0769 TOTAL EXC PITUITARY NOS 
0771 PITUITARY FOSSA EXPLORAT 



0772 PITUITARY GLAND INCISION 

0779 PITUITARY OPERATION NEC 

0780 THYMECTOMY NOS 

0781 PART EXCISION OF THYMUS 

0782 TOTAL EXCISION OF THYMUS 

0791 THYMUS FIELD EXPLORATION 

0792 INCISION OF THYMUS 

0793 REPAIR OF THYMUS 

0794 THYMUS TRANSPLANTATION 
0799 THYMUS OPERATION NEC 
0811 EYELID BIOPSY 

0820 REMOVE EYELID LESION NOS 

0821 CHALAZION EXCISION 

0822 EXCISE MINOR LES LID NEC 

0823 EXC MAJ LES LID PRT-THIC 

0824 EXC MAJ LES LID FUL-THIC 

0825 DESTRUCTION LID LESION 

0831 PTOSIS REP-FRONT MUS SUT 

0832 PTOSIS REP-FRON MUS SLNG 

0833 PTOSIS REP-LEVAT MUS ADV 

0834 PTOSIS REP-LEVAT MUS NEC 

0835 PTOS REP -TARSAL TECHNIQ 

0836 BLEPHAROPTOS REPAIR NEC 

0837 REDUC OVERCORRECT PTOSIS 

0838 CORRECT LID RETRACTION 

0841 THERMOCAUT/ENTROPION REP 

0842 SUTURE ENTROPION REPAIR 

0843 WEDG RESEC ENTROPION REP 

0844 LID RECONS ENTROPION REP 
0849 ENTROPION/ECTROP REP NEC 

0851 CANTHOTOMY 

0852 BLEPHARORRHAPHY 

0859 ADJUST LID POSITION NEC 

0861 LID RECONST W SKIN GRAFT 

0862 LID RECONST W MUC GRAFT 

0863 LID RECONST W HAIR GRAFT 

0864 LID RECON-TARSOCONJ FLAP 

0869 LID RECONSTR W GRAFT NEC 

0870 LID RECONSTRUCTION NOS 

0871 LID MARG RECON-PART THIC 

0872 LID RECONS-PART THIC NEC 

0873 LID MARG RECONS FUL THIC 

0874 LID RECONST-FUL THIC NEC 

0881 LINEAR REP LID LACER 

0882 LID MARG LAC RX-PART TH 

0883 LID LACER RX-PRT TH NEC 

0884 LID MARG LAC RX-FUL THIC 

0885 LID LAC RX-FUL THIC NEC 

0886 LOWER LID RHYTIDECTOMY 

0887 UPPER LID RHYTIDECTOMY 
0889 EYELID REPAIR NEC 

0891 ELECTROSURG LID EPILAT 

0892 CRYOSURG LID EPILATION 

0893 EYELID EPILATION NEC 



19 



Table 2.7— Continued 
ICD-9-CM operating room procedure codes 



0899 EYELID OPERATION NEC 

090 LACRIMAL GLAND INCISION 

0911 LACRIMAL GLAND BIOPSY 

0912 LACRIMAL SAC BIOPSY 

0919 LACRIMAL SYS DX PROC NEC 

0920 EXC LACRIMAL GLAND NOS 

0921 EXCIS LES LACRIMAL GLAND 

0922 PART DACRYOADENECT NEC 

0923 TOTAL DACRYOADENECTOMY 
093 OTHER LACRIMAL GLAND OPS 

0941 LACRIMAL PUNCTUM PROBE 

0942 LAC CANALICULI PROBE 

0943 NASOLACRIMAL DUCT PROBE 

0944 NASOLAC DUCT INTUBAT 
0949 LAC PASSAGE MANIP NEC 

0951 LAC PUNCTUM INCISION 

0952 LAC CANALICULI INCISION 

0953 LACRIMAL SAC INCISION 
0959 LACRIM PASSAGE INCIS NEC 
096 LACRIM SAC/PASSAGE EXCIS 
0971 CORRECT EVERTED PUNCTUM 
09 72 PUNCTUM REPAIR NEC 

0973 CANALICULUS REPAIR 

0981 DACRYOCYSTORHINOSTOMY 

0982 CONJUNCTIVOCYSTORHINOST 

0983 CONJUNCTIVORHINOS W TUBE 
0991 LAC PUNCTUM OBLITERATION 
0999 LACRIMAL SYSTEM OP NEC 

100 INCISE/REMOV CONJUNCT FB 

101 CONJUNCTIVA INCISION NEC 
1021 CONJUNCTIVAL BIOPSY 
102S CONJUNCTIVA DX PROC NEC 

1031 EXCISE CONJUNCTIV LESION 

1032 DESTRUCT CONJUNC LES NEC 

1033 OTH CONJUNC DESTRUC PROC 

1041 SYMBLEPH REP W FREE GRFT 

1042 GRAFT CONJUNC CUL-DE-SAC 

1043 CONJUN CUL-DE-SAC RX NEC 

1044 CONJUNC FREE GRAFT NEC 
1049 CONJUNCTIVOPLASTY NEC 

105 CONJUNC/LID ADHESIOLYSIS 

106 REPAIR CONJUNCT LACERAT 
1091 SUBCONJUNCTIVAL INJECT 
1099 CONJUNCTIVAL OP NEC 

110 MAGNET REMOVAL CORNEA FB 

111 CORNEAL INCISION 

1121 CORNEAL SCRAPE FOR SMEAR 

1122 CORNEAL BIOPSY 
1129 CORNEAL DX PROC NEC 

1131 PTERYGIUM TRANSPOSITION 

1132 PTERYG EXC W CORNEA GRFT 
1139 PTERYGIUM EXCISION NEC 

1141 MECH REMOV CORNEA EPITH 

1142 THERMOCAUT CORNEA LESION 



1143 CRYOTHERAP CORNEA LESION 

1149 DESTRUCT CORNEA LES NEC 

1151 SUTURE CORNEA LACERATION 

1152 REP CORNEA POSTOP DEHISC 

1153 RX CORNEA LAC W CON J FLP 

1159 CORNEAL REPAIR NEC 

1160 CORNEAL TRANSPLANT NOS 

1161 LAM KERATPLAST W AUTGRFT 

1162 LAMELLAR KERATOPLAST NEC 

1163 PERF KERATOPL W AUTOGRFT 

1164 PERFORAT KERATOPLAST NEC 
1169 CORNEAL TRANSPLANT NEC 

1171 KERATOMELEUSIS 

1172 KERATOPHAKIA 

1173 KERATOPROSTHESIS 

1174 THERMOKERATOPLASTY 
1179 CORNEA RECONSTRUCT NEC 

1191 CORNEAL TATTOOING 

1192 REMOVE CORNEAL IMPLANT 

1199 CORNEAL OPERATION NEC 

1200 REMOV ANT SEGMNT FB NOS 

1201 MAGNET REMOV ANT SEG FB 

1202 NONMAG REMOV ANT SEG FB 

1211 IRIDOTOMY W TRANSFIXION 

1212 IRIDOTOMY NEC 

1213 PROLAPSED IRIS EXCISION 

1214 IRIDECTOMY NEC 

1221 DX AS PI RAT -ANT CHAMBER 

1222 IRIS BIOPSY 

1229 ANT SEGMENT DX PROC NEC 

1231 GONIOSYNECHIAE LYSIS 

1232 ANT SYNECHIA LYSIS NEC 

1233 POST SYNECHIAE LYSIS 

1234 CORNEOVITREAL ADHESIOLYS 

1235 COREOPLASTY 

1239 IRIDOPLASTY NEC 

1240 REMOV ANT SEGMNT LES NOS 

1241 NONEXC DESTRUC IRIS LES 

1242 EXCISION OF IRIS LESION 

1243 NONEXC DESTR CIL BOD LES 

1244 EXCISE CILIARY BODY LES 

1251 GONIOPUNCTURE 

1252 GONIOTOMY 

1253 GONIOTOMY W GONIOPUNCTUR 

1254 TRABECULOTOMY AB EXTERNO 

1255 CYCLODIALYSIS 

1259 FACILIT INTRAOC CIRC NEC 

1261 TREPHIN SCLERA W IRIDECT 

1262 THERMCAUT SCLER W IRIDEC 

1263 IRIDENCLEISIS/IRIDOTASIS 

1264 TRABECULECTOM AB EXTERNO 

1265 SCLER FISTULIZ W IRIDECT 

1266 POSTOP REVIS SCL FISTUL 
1269 SCLER FISTULIZING OP NEC 



20 



Table 2.7— Continued 
ICD-9-CM operating room procedure codes 



1271 CYCLODIATHERMY 

1272 CYCLOCRYOTHERAPY 

1273 CYCLOPHOTOCOAGULATION 

1274 CIL BODY DIMINUTION NOS 
1279 GLAUCOMA PROCEDURE NEC 

1281 SUTURE SCLERAL LACER 

1282 SCLERAL FISTULA REPAIR 

1283 REVIS ANT SEG OP WND NEC 

1284 DESTRUCT SCLERAL LESION 

1285 REPAIR STAPHYLOM W GRAFT 

1286 REP SCLER STAPHYLOMA NEC 

1287 GRAFT REINFORCE SCLERA 

1288 SCLERA REINFORCEMENT NEC 

1289 SCLERAL OPERATION NEC 

1291 THERAPEUT EVAC ANT CHAMB 

1292 ANTERIOR CHAMBER INJECT 

1293 REMOV EPITHEL DOWNGROWTH 

1297 IRIS OPERATION NEC 

1298 CILIARY BODY OP NEC 

1299 ANTERIOR CHAMBER OP NEC 

1300 REMOVE FB LENS NOS 

1301 MAGNET REMOVE FB LENS 

1302 NONMAGNET REMOVE FB LENS 
1311 TEMP- INF INTRCAP LENS EX 
1319 INTRACAPSUL LENS EXT NEC 

132 LINEAR EXTRACAP LENS EXT 

133 SIMPL ASPIR LENS EXTRACT 

1341 CATARAC PHACOEMULS/ASPIR 

1342 POST CATARAC FRAG/ASPIR 

1343 CATARACT FRAG/ASPIR NEC 
1351 TEMP- INF XTRACAP LENS EX 
1359 EXTRACAP LENS EXTRAC NEC 

1361 PRIM MEM CATAR DISCISS 

1362 PRIM MEMBRN CATAR EXCIS 

1363 PRIM MEM CATAR FRAGMEN 

1364 AFTER-CATAR DISCISSION 

1365 AFTER -CATARACT EXCISION 

1366 AFTER CATAR FRAGMNTATION 

1369 CATARACT EXTRACTION NEC 

1370 INSERT PSEUDOPHAKOS NOS 

1371 INSERT LENS AT CATAR EXT 

1372 SECONDARY INSERT LENS 

138 IMPLANTED LENS REMOVAL 

139 OTHER OPERATIONS ON LENS 

1400 REMOV POST SEGMNT FB NOS 

1401 MAGNET REMOV POST SEG FB 

1402 NONMAG REMOV POST SEG FB 
1411 DIAGNOST VITREOUS ASPIR 
1419 DX PROC POST SEG NEC 

1421 CHORIORET LES DIATHERMY 

1422 CHORIORETIN LES CRYOTHER 

1426 CHORIORET LES RADIOTHER 

1427 CHORIORET LES RAD IMPLAN 
1429 CHORIORET LES DESTR NEC 



1431 RETINAL TEAR DIATHERMY 

1432 RETINAL TEAR CRYOTHERAPY 
1439 RETINAL TEAR REPAIR NEC 
1441 SCLERAL BUCKLE W IMPLANT 
1449 SCLERAL BUCKLING NEC 

1451 DETACH RETINA -DIATHERMY 

1452 DETACH RETINA-CRYOTHERAP 

1453 DETACH RETINA XENON COAG 

1454 DETACH RETINA LASER COAG 

1455 DETACH RET PHOTOCOAG NOS 
1459 REPAIR RETINA DETACH NEC 
146 REMOV PROS MAT POST SEG 

1471 ANTERIOR REMOV VITREOUS 

1472 VITREOUS REMOVAL NEC 

1473 ANTERIOR MECHAN VITRECT 

1474 MECH VITRECTOMY NEC 

1475 VITREOUS SUBSTITUT INJEC 
1479 VITREOUS OPERATION NEC 
149 OTHER POST SEGMENT OPS 
1501 EXTRAOC MUSC-TEND BIOPSY 
1509 EXTRAOC MUSC DX PROC NEC 

1511 ONE EXTRAOC MUS RECESS 

1512 1 EXTRAOC MUSCL ADVANCE 

1513 1 EXTRAOC MUSCL RESECT 
1519 XTRAOC MUS OP/DETACH NEC 

1521 LENGTHEN 1 EXTRAOC MUSC 

1522 SHORTEN 1 EXTRAOC MUSC 
1529 OP ON 1 EXTRAOC MUSC NEC 

153 TEMP DETACH >1 XTROC MUS 

154 OTH OP ON >L EXTRAOC MUS 

155 EXTRAOCUL MUS TRANSPOSIT 

156 REVIS EXTRAOC MUSC SURG 

157 EXTRAOC MUSC INJ REPAIR 
159 OTH EXTRAOC MUS -TEND OP 

1601 ORBITOTOMY W BONE FLAP 

1602 ORBITOTOMY W IMPLANT 
1609 ORBITOTOMY NEC 

161 REMOVE PENETRAT FB EYE 

1622 DIAGNOSTIC ASP OF ORBIT 

1623 EYEBALL ORBIT BIOPSY 
1629 EYEBAL/ORBIT DX PROC NEC 
1631 EYE EVISC W SYNCH IMPLAN 
1639 EYEBALL EVISCERATION NEC 

1641 EYE ENUC/IMPLAN/MUSC ATT 

1642 EYE ENUC W IMPLANT NEC 
1649 EYEBALL ENUCLEATION NEC 

1651 RADICAL ORB ITOMAXILLECT 

1652 ORBIT EXENT W BONE REMOV 
1659 ORBITAL EXENTERATION NEC 

1661 2NDRY OCULAR IMP INSERT 

1662 REVIS/REINSERT OCUL IMP 

1663 REVIS ENUC SOCKET W GRFT 

1664 ENUC SOCKET REVIS NEC 

1665 2NDRY EXENT CAVITY GRAFT 



21 



Table 2.7— Continued 
ICD-9-CM operating room procedure codes 



1666 REVIS EXENTER CAVITY NEC 

1669 2ND OP POST EYE REM NEC 

1671 REMOVE OCULAR IMPLANT 

1672 REMOVE ORBITAL IMPLANT 

1681 REPAIR OF ORBITAL WOUND 

1682 REPAIR EYEBALL RUPTURE 
1689 EYE/ORBIT INJ REPAIR NEC 

1692 EXCISION ORBITAL LESION 

1693 EXCISION EYE LESION NOS 

1698 OPERATION ON ORBIT NEC 

1699 OPERATION ON EYEBALL NEC 
1821 PREAURICULAR SINUS EXCIS 
1831 RAD EXCIS EXT EAR LES 
1839 EXCIS EXTERNAL EAR NEC 

185 CORRECTION PROMINENT EAR 

186 EXT AUDIT CANAL RECONSTR 

1871 CONSTRUCTION EAR AURICLE 

1872 REATTACH AMPUTATED EAR 
1879 PLASTIC REP EXT EAR NEC 

189 OTHER EXT EAR OPERATIONS 

190 STAPES MOBILIZATION 
1911 STAPEDECT W REPLAC INCUS 
1919 STAPEDECTOMY NEC 

1921 REV STAPDEC W INCUS REPL 

1929 STAPEDECTOMY REVIS NEC 

193 OSSICULAR CHAIN OP NEC 

194 MYRINGOPLASTY 

1952 TYPE 2 TYMPANOPLASTY 

1953 TYPE 3 TYMPANOPLASTY 

1954 TYPE 4 TYMPANOPLASTY 

1955 TYPE 5 TYMPANOPLASTY 
196 TYMPANOPLASTY REVISION 
199 MIDDLE EAR REPAIR NEC 
2001 MYRINGOTOMY W INTUBATION 

2021 MASTOID INCISION 

2022 PETRUS PYRAM AIR CEL INC 

2023 MIDDLE EAR INCISION 
2032 MID INNER EAR BIOPSY 
2039 MID/IN EAR DX PROC NEC 

2041 SIMPLE MASTOIDECTOMY 

2042 RADICAL MASTOIDECTOMY 
2049 MASTOIDECTOMY NEC 

2051 EXCISE MIDDLE EAR LESION 

2059 MIDDLE EAR EXCISION NEC 

2061 INNER EAR FENESTRATION 

2062 REVIS INNER EAR FENESTRA 

2071 ENDOLYMPHATIC SHUNT 

2072 INNER EAR INJECTION 
2079 INC/EXC/DESTR IN EAR NEC 

2091 TYMPANOSYMPATHECTOMY 

2092 MASTOIDECTOMY REVISION 

2093 REPAIR OVAL/ROUND WINDOW 
2095 ELECMAG HEAR AID IMPLANT 
2099 MID-INNER EAR OPS NEC 



2104 ETHMOID ART LIGAT-EPIST 

2105 MAX ART LIG FOR EPISTAX 

2106 EXT CAROT ART LIG-EPIST 

2107 NASAL SEPT GRFT -EPISTAX 
2109 EPISTAXIS CONTROL NEC 

214 RESECTION OF NOSE 

215 SUBMUC NASAL SEPT RESECT 

2161 DIATHER/CRYO TURBINECTOM 

2162 TURBINATE FRACTURE 
2169 TURBINECTOMY NEC 

2172 OPEN REDUCTION NASAL FX 

2182 NASAL FISTULA CLOSURE 

2183 TOT NASAL RECONSTRUCTION 

2184 REVISION RHINOPLASTY 

2185 AUGMENTATION RHINOPLASTY 

2186 LIMITED RHINOPLASTY 

2187 RHINOPLASTY NEC 

2188 SEPTOPLASTY NEC 

2189 NASAL REPAIR NEC 
2199 NASAL OPERATION NEC 
2231 RADICAL MAXILLARY ANTROT 
2239 EXT MAXILLARY ANTROT NEC 

2241 FRONTAL SINUSOTOMY 

2242 FRONTAL SINUSECTOMY 

2250 SINUSOTOMY NOS 

2251 ETHMOIDOTOMY 

2252 SPHENOIDOTOMY 

2253 MULTIPLE SINUS INCISION 

2260 SINUSECTOMY NOS 

2261 C-LUC EXC MAX SINUS LES 

2262 EXC MAX SINUS LESION NEC 

2263 ETHMOIDECTOMY 

2264 SPHENOIDECTOMY 

2271 NASAL SINUS FISTULA CLOS 

2279 NASAL SINUS REPAIR NEC 

229 OTHER NASAL SINUS OPS 

242 GINGIVOPLASTY 

244 EXC OF DENTAL LES OF JAW 

245 ALVEOLOPLASTY 

251 DESTRUCTION TONGUE LES 

252 PARTIAL GLOSSECTOMY 

253 COMPLETE GLOSSECTOMY 

254 RADICAL GLOSSECTOMY 
2559 REPAIR OF TONGUE NEC 
2594 OTHER GLOSSOTOMY 
2599 TONGUE OPERATION NEC 
2621 SALIVARY C^ST MARSUPIAL 

2629 SALIV LESION EXCIS NEC 

2630 SIALOADENECTOMY NOS 

2631 PARTIAL SIALOADENECTOMY 

2632 COMPLETE SIALOADENECTOMY 

2641 SUTURE OF SALIV GLND LAC 

2642 SALIVARY FISTULA CLOSURE 
2649 SALIVARY REPAIR NEC 



22 



Table 2.7— Continued 
ICD-9-CM operating room procedure codes 



2699 SALIVARY OPERATION NEC 

270 DRAIN FACE MOUTH FLOOR 

271 INCISION OF PALATE 

2721 BONY PALATE BIOPSY 

2722 UVULA BIOPSY 

2731 LOC EXC BONY PALATE LES 

2732 WIDE EXC BONY PALATE LES 

2742 WIDE EXCISION OF LIP LES 

2743 EXCISION OF LIP LES NEC 
2749 EXCISION OF MOUTH NEC 

2753 CLOSURE OF MOUTH FISTULA 

2754 REPAIR OF CLEFT LIP 

2755 FULL-THICK GRFT TO MOUTH 

2756 SKIN GRAFT TO MOUTH NEC 

2757 PEDICLE ATTACH TO MOUTH 
2759 MOUTH REPAIR NEC 

2761 SUTURE OF PALATE LACERAT 

2762 CLEFT PALATE CORRECTION 

2763 REVIS CLEFT PALAT REPAIR 
2769 OTH PLASTIC REPAIR PALAT 

2771 INCISION OF UVULA 

2772 EXCISION OF UVULA 

2773 REPAIR OF UVULA 

2779 OTHER UVULA OPERATIONS 

2792 MOUTH INCISION NOS 

2799 ORAL CAVITY OPS NEC 

280 PERITONSILLAR I D 

2811 TONSIL ADENOID BIOPSY 

2819 TONSIL ADENOID DX OP NEC 

282 TONSILLECTOMY 

283 TONSILLECTOMY/ADENOIDEC 

284 EXCISION OF TONSIL TAG 

285 EXCISION LINGUAL TONSIL 

286 ADENOIDECTOMY 

287 HEMORR CONTRL POST T A 

2891 INCIS TO REMOV TONSIL FB 

2892 EXCIS TONSIL/ADENOID LES 
2899 TONSIL/ADENOID OPS NEC 
290 PHARYNGOTOMY 

292 EXC BRANCHIAL CLEFT CYST 

293 DESTRUCT PHARYNGEAL LES 

294 PLASTIC OP ON PHARYNX 

2951 SUTURE OF PHARYNGEAL LAC 

2952 CLOS BRANCH CLEFT FISTUL 

2953 CLOS PHARYNX FISTULA NEC 

2954 LYSIS PHARYNGEAL ADHES 
2959 PHARYNGEAL REPAIR NEC 
2992 DIVIS GLOSSOPHARYNG NERV 
2999 PHARYNGEAL OPERATION NEC 
3001 LARYNX CYST MARSUPIALIZ 
3009 DESTRUCT LARYNX LES NEC 
301 HEMILARYNGECTOMY 

3021 EPIGLOTTIDECTOMY 

3022 VOCAL CORDECTOMY 



3029 OTHER PART LARYNGECTOMY 

303 COMPLETE LARYNGECTOMY 

304 RADICAL LARYNGECTOMY 
3121 MEDIASTINAL TRACHEOSTOMY 
3129 OTHER PERM TRACHEOSTOMY 
313 INCIS LARYNX TRACHEA NEC 
315 LOCAL DESTRUC LARYNX LES 

3161 SUTURE OF LARYNGEAL LAC 

3162 LARYNGEAL FISTULA CLOS 

3163 LARYNGOSTOMY REVISION 

3164 LARYNGEAL FX REPAIR 
3169 OTHER LARYNGEAL REPAIR 

3171 SUTURE OF TRACHEAL LACER 

3172 CLOSURE OF TRACHEOSTOMY 

3173 TRACHEA FISTULA CLOS NEC 

3174 REVISION OF TRACHEOSTOMY 

3175 TRACHEAL RECONSTRUCTION 
3179 OTHER TRACHEAL REPAIR 

3191 LARYNGEAL NERV DIVISION 

3192 LYSIS TRACH/LARYNX ADHES 

3198 OTH LARYNGEAL OPERATION 

3199 OTHER TRACHtAL OPERATION 

320 LOCAL DESTRUCT BRONC LES 

321 OTHER BRONCHIAL EXCISION 
3221 EMPHYSEMA BLEB PLICATION 
3229 DESTROY LOC LUNG LES NEC 

323 SEGMENTAL LUNG RESECTION 

324 LOBECTOMY OF LUNG 

325 COMPLETE PNEUMONECTOMY 

326 RAD DISSEC THORAC STRUCT 

329 OTHER EXCISION OF LUNG 

330 INCISION OF BRONCHUS 

331 INCISION OF LUNG 

3325 OTHER BRONCHIAL BIOPSY 

3327 OTHER LUNG BIOPSY 

3328 BRONCHIAL DX PROC NEC 

3329 LUNG DIAGNOSTIC PROC NEC 
3334 THORACOPLASTY 

3339 SURG COLLAPS OF LUNG NEC 

3341 BRONCHIAL LACERAT SUTURE 

3342 BRONCHIAL FISTULA CLOS 

3343 LUNG LACERATION CLOSURE 

3348 BRONCHIAL REPAIR NEC 

3349 LUNG REPAIR NEC 
335 LUNG TRANSPLANT 
3392 BRONCHIAL LIGATION 
339 3 PUNCTURE OF LUNG 

3398 BRONCHIAL OPERATION NEC 

3399 LUNG OPERATION NEC 

3402 EXPLORATORY THORACOTOMY 

3403 REOPEN THORACOTOMY SITE 
341 INCISION OF MEDIASTINUM 

3421 TRANSPLEURA THORACOSCOPY 

3422 MEDIASTINOSCOPY 



23 



419-177 0-84—3 



Table 2.7 — Continued 
ICD-9-CM operating room procedure codes 



3426 OTHER MEDIASTINAL BIOPSY 

3427 BIOPSY OF DIAPHRAGM 

3428 DX PROCEDURE THORAX NEC 

3429 DX PROC MEDIASTINUM NEC 

343 DESTRUCT MEDIASTIN LES 

344 DESTRUCT CHEST WALL LES 
3451 DECORTICATION OF LUNG 
3459 OTHER PLEURAL EXCISION 
346 SCARIFICATION OF PLEURA 

3473 CLOS THORACIC FISTUL NEC 

3474 PECTUS DEFORMITY REPAIR 
3479 OTHER CHEST WALL REPAIR 

3481 EXCISE DIAPHRAGM LESION 

3482 SUTURE DIAPHRAGM LACERAT 

3483 CLOSE DIAPHRAGM FISTULA 

3484 OTHER DIAPHRAGM REPAIR 

3485 IMPLANT DIAPHRA PACEMAKE 
3489 DIAPHRAGM OPERATION NEC 
349 3 REPAIR OF PLEURA 

3499 THORACIC OPERATION NEC 

3500 CLOSED VALVOTOMY NOS 

3501 CLOSED AORTIC VALVOTOMY 

3502 CLOSED MITRAL VALVOTOMY 

3503 CLOSED PULMON VALVOTOMY 

3504 CLOSED TRICUSP VALVOTOMY 

3510 OPEN VALVULOPLASTY NOS 

3511 OPN AORTIC VALVULOPLASTY 

3512 OPN MITRAL VALVULOPLASTY 

3513 OPN PULMON VALVULOPLASTY 

3514 OPN TRICUS VALVULOPLASTY 

3520 REPLACE HEART VALVE NOS 

3521 REPLACE AORT VALV-TISSUE 

3522 REPLACE AORTIC VALVE NEC 

3523 REPLACE MITR VALV-TISSUE 

3524 REPLACE MITRAL VALVE NEC 

3525 REPLACE PULM VALV-TISSUE 

3526 REPLACE PULMON VALVE NEC 

3527 REPLACE TRIC VALV-TISSUE 

3528 REPLACE TRICUSP VALV NEC 

3531 PAPILLARY MUSCLE OPS 

3532 CHORDAE TENDINEAE OPS 

3533 ANNULOPLASTY 

3534 INFUNDIBULECTOMY 

3535 TRABECUL CARNEAE CORD OP 
3539 TISS AD J TO VALV OPS NEC 
3542 CREATE SEPTAL DEFECT 

3550 PROSTH REP HRT SEPTA NOS 

3551 PROS REP ATRIAL DEF-OPN 

3552 PROS REPAIR ATRIA DEF-CL 

3553 PROST REPAIR VENTRIC DEF 

3554 PROS REP ENDOCAR CUSHION 

3560 GRFT REPAIR HRT SEPT NOS 

3561 GRART REPAIR ATRIAL DEF 

3562 GRAFT REPAIR VENTRIC DEF 



3563 GRFT REP ENDOCAR CUSHION 

3570 HEART SEPTA REPAIR NOS 

3571 ATRIA SEPTA DEF REP NEC 

3572 VENTR SEPTA DEF REP NEC 

3573 ENDOCAR CUSHION REP NEC 

3581 TOT REPAIR TETRAL FALLOT 

3582 TOTAL REPAIR OF TAPVC 

3583 TOT REP TRUNCUS ARTERIOS 

3591 INTERAT VEN RETRN TRANS P 

3592 CONDUIT RT VENT-PUL ART 

3593 CONDUIT LEFT VENTR-AORTA 

3594 CONDUIT ARTIUM-PULM ART 

3595 HEART REPAIR REVISION 

3598 OTHER HEART SEPTA OPS 

3599 OTHER HEART VALVE OPS 
360 REMOV CORONAR ART OBSTR 

3610 AORTOCORONARY BYPASS NOS 

3611 AORTOCOR BYPAS-1 COR ART 

3612 AORTOCOR BYPAS-2 COR ART 

3613 AORTOCOR BYPAS-3 COR ART 

3614 AORTCOR BYPAS-4+ COR ART 

3615 1 INT MAM-COR ART BYPASS 

3616 2 INT MAM-COR ART BYPASS 
3619 HRT REVAS BYPS ANAS NEC 

362 ARTERIAL IMPLANT REVASC 

363 HEART REVASCULARIZAT NEC 
3691 CORON VESS ANEURYSM REP 
3699 HEART VESSEL OP NEC 

3710 INCISION OF HEART NOS 

3711 CARDIOTOMY 

3712 PERICARDIOTOMY 
3724 PERICARDIAL BIOPSY 

3731 PERICARDECTOMY 

3732 HEART ANEURYSM EXCISION 

3733 HEART LES EXCISION NEC 

374 HEART PERICARD REPAIR 

375 HEART TRANSPLANTATION 

3761 PULSATION BALLOON IMPLAN 

3762 IMPLANT HRT ASST SYS NEC 

3763 REPLACE HRT ASSIST SYST 

3764 REMOVE HEART ASSIST SYS 
3770 INSERT CARD PACEMAK NOS 

3773 INSER PERM PACEM ATRI-TV 

3774 INSER PERM PACEM VENT-TV 
3 775 INSERT PERM PACEM-TV NOS 
37 76 INSER PERM PACEM EPICARD 
3777 INSERT PERM PACEMAK NOS 

3781 REPLAC TRANSVEN ELECTROD 

3782 REPLACE EPICARD ELECTROD 

3783 REMOV TRANSVEN ELECTRODE 

3784 REMOVE EPICARD ELECTRODE 

3785 REPLACE PULSE GENERATOR 

3786 REMOVE PACEMAKER SYSTEM 
3789 REVIS PACEMAKER SYS NEC 



Table 2.7— Continued 
ICD-9-CM operating room procedure codes 



3791 OPN CHEST CARDIAC MASSAG 

3799 OTHER HEART/PERICARD OPS 

3800 INCISION OF VESSEL NOS 

3801 INTRACRAN VESSEL INCIS 

3802 HEAD/NECK VES INCIS NEC 

3803 UPPER LIMB VESSEL INCIS 

3804 INCISION OF AORTA 

3805 THORACIC VESSEL INC NEC 

3806 ABDOMEN ARTERY INCISION 

3807 ABDOMINAL VEIN INCISION 

3808 LOWER LIMB ARTERY INCIS 

3809 LOWER LIMB VEIN INCISION 

3810 ENDARTERECTOMY NOS 

3811 INTRACRAN ENDARTERECTOMY 

3812 HEAD NECK ENDARTER NEC 

3813 UPPER LIMB ENDARTERECTOM 

3814 ENDARTERECTOMY OF AORTA 

3815 THORACIC ENDARTERECTOMY 

3816 ABDOMINAL ENDARTERECTOMY 
3818 LOWER LIMB ENDARTERECT 
3821 BLOOD VESSEL BIOPSY 

3829 BLOOD VESSEL DX PROC NEC 

3830 VESSEL RESECT/ANAST NOS 

3831 INTRACRAN VES RESEC-ANAS 

3832 HEAD/NECK VES RESEC-ANAS 

3833 ARM VESSEL RESECT/ANAST 

3834 AORTA RESECTION ANAST 

3835 THOR VESSEL RESECT/ANAST 

3836 ABD VESSEL RESECT/ANAST 

3837 ABD VEIN RESECT ANAST 

3838 LEG ARTERY RESECT/ANAST 

3839 LEG VEIN RESECT/ANASTOM 

3840 VESSEL RESECT/REPLAC NOS 

3841 INTRACRAN VES RESEC-REPL 

3842 HEAD/NECK VES RESEC-REPL 

3843 ARM VES RESECT W REPLACE 

3844 AORTA RESECT W REPLACE 

3845 THOR VES RESECT W REPLAC 

3846 ABD ARTERY RESEC W REPLA 

3847 ABD VEIN RESECT W REPLAC 

3848 LEG ARTERY RESEC W REPLA 

3849 LEG VEIN RESECT W REPLAC 

3850 VARICOSE V LIG-STRIP NOS 

3851 INTCRAN VAR V LIG-STRIP 

3852 HEAD/NECK VAR V LIG-STR 

3853 ARM VARICOSE V LIG-STRIP 
3855 THORAC VAR V LIG-STRIP 
3857 ABD VARICOS V LIGA-STRIP 

3859 LEG VARICOS V LIGA-STRIP 

3860 EXCISION OF VESSEL NOS 

3861 INTRACRAN VESSEL EXCIS 

3862 HEAD/NECK VESSEL EXCIS 

3863 ARM VESSEL EXCISION 

3864 EXCISION OF AORTA 



3865 THORACIC VESSEL EXCISION 

3866 ABDOMINAL ARTERY EXCIS 

3867 ABDOMINAL VEIN EXCISION 

3868 LEG ARTERY EXCISION 

3869 LEG VEIN EXCISION 

387 PLICATION OF VENA CAVA 

3880 SURG VESSEL OCCLUS NEC 

3881 OCCLUS INTRACRAN VES NEC 

3882 OCCLUS HEAD/NECK VES NEC 

3883 OCCLUDE ARM VESSEL NEC 

3884 OCCLUDE AORTA NEC 

3885 OCCLUDE THORACIC VES NEC 

3886 OCCLUDE ABD ARTERY NEC 

3887 OCCLUDE ABD VEIN NEC 

3888 OCCLUDE LEG ARTERY NEC 

3889 OCCLUDE LEG VEIN NEC 

390 SYSTEMIC-PULM ART SHUNT 

391 INTRA-ABD VENOUS SHUNT 

3921 CAVAL-PULMON ART ANASTOM 

3922 AORTA-SUBCLV-CAROT BYPAS 

3923 INTRATHORACIC SHUNT NEC 

3924 AORTA-RENAL BYPASS 

3925 AORTA- ILIAC -FEMOR BYPASS 

3926 INTRA-ABDOMIN SHUNT NEC 

3927 DIALYSIS ARTERIOVENOSTOM 

3929 VASC SHUNT BYPASS NEC 

3930 SUTURE OF VESSEL NOS 

3931 SUTURE OF ARTERY 

3932 SUTURE OF VEIN 

3941 POSTOP VASC OP HEM CONTR 

3942 REVIS REN DIALYSIS SHUNT 

3943 REMOV REN DIALYSIS SHUNT 
3949 VASC PROC REVISION NEC 

3951 CLIPPING OF ANEURYSM 

3952 ANEURYSM REPAIR NEC 

3953 ARTERIOVEN FISTULA REP 

3954 RE-ENTRY OPERATION 

3955 REIMPLAN ABERR RENAL VES 

3956 REPAIR VESS W TIS PATCH 

3957 REP VESS W SYNTH PATCH 

3958 REPAIR VESS W PATCH NOS 

3959 REPAIR OF VESSEL NEC 

3961 EXTRACORPOREAL CIRCULAT 

3962 HYPOTHERMIA W OPEN HEART 

3963 CARDIOPLEGIA 

3964 INTRAOP CARDIAC PACEMAK 

397 PERIARTER SYMPATHECTOMY 

398 VASCULAR BODY OPERATIONS 

3991 FREEING OF VESSEL 

3992 VEIN INJECT -SCLEROS AGNT 

3993 INSERT VES-TO-VES CANNUL 

3994 REPLAC VES-TO-VES CANNUL 
3996 TOTAL BODY PERFUSION 
3998 HEMORRHAGE CONTROL NOS 



25 



Table 2.7— Continued 
ICD-9-CM operating room procedure codes 



3999 VESSEL OPERATION NEC 

400 INCIS LYMPHATIC STRUCTUR 

4011 LYMPHATIC STRUCT BIOPSY 

4019 LYMPHATIC DIAG PROC NEC 

4021 EXCIS DEEP CERVICAL NODE 

4022 EXCISE INT MAMMARY NODE 

4023 EXCISE AXILLARY NODE 

4024 EXCISE INGUINAL NODE 
4029 SIMP EXC LYMPH STRUC NEC 
403 REGIONAL LYMPH NODE EXC 

4040 RAD NECK DISSECTION NOS 

4041 UNILAT RAD NECK DISSECT 

4042 BILAT RAD NECK DISSECT 

4050 RAD NODE DISSECTION NOS 

4051 RAD DISSEC AXILLARY NODE 

4052 RAD DISSEC PERIAORT NODE 

4053 RAD DISSECT ILIAC NODES 

4054 RADICAL GROIN DISSECTION 
4059 RAD NODE DISSECTION NEC 

4061 THORAC DUCT CANNULATION 

4062 THORACIC DUCT FISTULIZAT 

4063 CLOSE THORACIC DUCT FIST 

4064 LIGATE THORACIC DUCT 
4069 THORACIC DUCT OP NEC 

409 LYMPH STRUCTURE OP NEC 

410 BONE MARROW TRANSPLANT 
412 SPLENOTOMY 

4133 SPLEEN BIOPSY NEC 

4141 SPLENIC CYST MARSUPIAL 

4142 EXC SPLENIC LESION/TISS 

4143 PARTIAL SPLENECTOMY 
415 TOTAL SPLENECTOMY 

4193 EXC OF ACCESSORY SPLEEN 

4194 SPLEEN TRANSPLANTATION 

4195 REPAIR OF SPLEEN 
4199 SPLEEN OPERATION NEC 
4201 ESOPHAGEAL WEB INCISION 

4209 ESOPHAGEAL INCISION NEC 

4210 ESOPHAGOSTOMY NOS 

4211 CERVICAL ESOPHAGOSTOMY 

4212 ESOPH POUCH EXTERIORIZAT 
4219 EXT FISTULIZAT ESOPH NEC 
4221 ESOPHAGOSCOPY BY INCIS 

4231 LOC EXCIS ESOPH DIVERTIC 

4232 LOCAL EXCIS ESOPHAG NEC 

4239 DESTRUCT ESOPHAG LES NEC 

4240 ESOPHAGECTOMY NOS 

4241 PARTIAL ESOPHAGECTOMY 

4242 TOTAL ESOPHAGECTOMY 

4251 THORAC ESOPHAGOESOPHAGOS 

4252 THORAC ESOPHAGOGASTROST 

4253 THORAC SM BOWEL INTERPOS 

4254 THORAC ESOPHAGOENTER NEC 

4255 THORAC LG BOWEL INTERPOS 



4256 THORAC ESOPHAGOCOLOS NEC 

4258 THORAC INTERPOSITION NEC 

4259 THORAC ESOPHAG ANAST NEC 

4261 STERN ESOPHAGOESOPHAGOST 

4262 STERN ESOPHAGOGASTROSTOM 

4263 STERN SM BOWEL INTERPOS 

4264 STERN ESOPHAGOENTER NEC 

4265 STERN LG BOWEL INTERPOS 

4266 STERN ESOPHAGOCOLOS NEC 

4268 STERN INTERPOSITION NEC 

4269 STERN ESOPHAG ANAST NEC 
427 ESOPHAGOMYOTOMY 

4282 SUTURE ESOPHAGEAL LACER 

4283 ESOPHAGOSTOMY CLOSURE 

4284 ESOPH FISTULA REPAIR NEC 

4285 ESOPHAG STRICTURE REPAIR 

4286 PROD SUBQ TUNNEL NO ANAS 

4287 ESOPHAGEAL GRAFT NEC 
4289 ESOPHAGEAL REPAIR NEC 
4291 INJECT/LIGAT ESOPH VARIX 
430 GASTROTOMY 

433 PYLOROMYOTOrtY 

4342 LOCAL GASTR EXCISION NEC 

4349 LOCAL GASTR DESTRUCT NEC 

435 PROXIMAL GASTRECTOMY 

436 DISTAL GASTRECTOMY 

43 7 PART GASTREC W JEJ ANAST 

4381 PART GAST W JEJ TRANSPOS 

4389 PARTIAL GASTRECTOMY NEC 

4391 TOT GAST W INTES INTERPO 

4399 TOTAL GASTRECTOMY NEC 

4400 VAGOTOMY NOS 

4401 TRUNCAL VAGOTOMY 

4402 HIGHLY SELECT VAGOTOMY 

4403 SELECTIVE VAGOTOMY NEC 
4411 TRANSABDOMIN GASTROSCOPY 
4415 GASTRIC BIOPSY NEC 

442 PYLOROPLASTY 

4431 HIGH GASTRIC BYPASS 

4439 GASTROENTEROSTOMY NEC 

4440 SUTURE PEPTIC ULCER NOS 

4441 SUT GASTRIC ULCER SITE 

4442 SUTURE DUODEN ULCER SITE 
445 REVISION GASTRIC ANASTOM 
4461 SUTURE GASTRIC LACERAT 

4463 CLOSE GASTRIC FISTUL NEC 

4464 GASTROPEXY 

4465 ESOPHAGOGASTROPLASTY 

4466 CREAT ESOPHAGASTR SPHINC 
4469 GASTRIC REPAIR NEC 

4491 LIGATE GASTRIC VARICES 

4492 INTRAOP GASTRIC MANIPUL 

4499 GASTRIC OPERATION NEC 

4500 INTESTINAL INCISION NOS 



26 



Table 2.7— Continued 
ICD-9-CM operating room procedure codes 



4501 DUODENAL INCISION 

4502 SMALL BOWEL INCISION NEC 

4503 LARGE BOWEL INCISION 
4511 TRANSAB SM BOWEL ENDOSC 
4515 SMALL BOWEL BIOPSY NEC 
4521 TRANSAB LG BOWEL ENDOSC 

4531 LOCAL EXCISION DUODENUM 

4532 DESTRUCT DUODEN LES NEC 

4533 LOCAL EXCIS SM BOWEL NEC 

4534 DESTR SM BOWEL LES NEC 
4541 LOCAL EXCISION LG BOWEL 

4549 DESTRUC LG BOWEL LES NEC 

4550 INTEST SEG ISOLAT NOS 

4551 SM BOWEL SEGMENT ISOLAT 

4552 LG BOWEL SEGMENT ISOLAT 

4561 MULT SEG SM BOWEL EXCIS 

4562 PART SM BOWEL RESECT NEC 

4563 TOTAL REMOVAL SM BOWEL 

4571 MULT SEG LG BOWEL EXCIS 

4572 CECECTOMY 

4573 RIGHT HEMICOLECTOMY 

4574 TRANSVERSE COLON RESECT 

4575 LEFT HEMICOLECTOMY 

4576 SIGMOIDECTOMY 

4579 PART LG BOWEL EXCIS NEC 

458 TOT INTRA -ABD COLECTOMY 

4590 INTESTINAL ANASTOM NOS 

4591 SM-TO-SM BOWEL ANASTOM 

4592 SM BOWEL-RECT STUMP ANAS 

4593 SMALL-TO-LARGE BOWEL NEC 

4594 LG-TO-LG BOWEL ANASTOM 

4601 SM BOWEL EXTERIORIZATION 

4602 RESECT EXT SEG SM BOWEL 

4603 LG BOWEL EXTERIORIZATION 

4604 RESECT EXT SEG LG BOWEL 

4610 COLOSTOMY NOS 

4611 TEMPORARY COLOSTOMY 

4612 PERM MAGNETIC COLOSTOMY 

4613 PERMANENT COLOSTOMY NEC 

4620 ILEOSTOMY NOS 

4621 TEMPORARY ILEOSTOMY 

4622 CONTINENT ILEOSTOMY 

4623 PERMANENT ILEOSTOMY NEC 

4640 INTEST STOMA REVIS NOS 

4641 SM BOWEL STOMA REVISION 

4642 PERICOLOST HERNIA REPAIR 

4643 LG BOWEL STOMA REVIS NEC 

4650 INTEST STOMA CLOSURE NOS 

4651 SM BOWEL STOMA CLOSURE 

4652 LG BOWEL STOMA CLOSURE 

4660 INTESTINAL FIXATION NOS 

4661 SM BOWEL-ABD WALL FIXAT 

4662 SMALL BOWEL FIXATION NEC 

4663 LG BOWEL-ABD WALL FIXAT 



4664 LARGE BOWEL FIXATION NEC 

4671 DUODENAL LACERAT SUTURE 

4672 DUODENAL FISTULA CLOSURE 

4673 SMALL BOWEL SUTURE NEC 

4674 CLOSE SM BOWEL FIST NEC 

4675 SUTURE LG BOWEL LACERAT 

4676 CLOSE LG BOWEL FISTULA 

4679 REPAIR OF INTESTINE NEC 

4680 INTRA-AB BOWEL MANIP NOS 

4681 INTRA -ABD SM BOWEL MANIP 

4682 INTRA-ABD LG BOWEL MANIP 

4691 MYOTOMY OF SIGMOID COLON 

4692 MYOTOMY OF COLON NEC 

4693 REVISE SM BOWEL ANASTOM 

4694 REVISE LG BOWEL ANASTOM 
4699 INTESTINAL OP NEC 

470 APPENDECTOMY 

471 INCIDENTAL APPENDECTOMY 

472 DRAIN APPENDICEAL ABSC 

4791 APPEND ICOSTOMY 

4792 CLOSE APPENDICEAL FISTUL 
4799 APPENDICEAL OPS NEC 

480 PROCTOTOMY 

481 PROCTOSTOMY 

4821 TRANSAB PROCTOSIGMOIDOSC 

4835 LOCAL EXCIS RECTAL LES 

4841 SOAVE SUBMUC RECT RESECT 

4849 PULL-THRU RECT RESEC NEC 

485 ABD-PERINEAL RECT RESECT 

4861 TRANSSAC RECTOS IGMOIDECT 

4862 ANT RECT RESECT W COLOST 

4863 ANTERIOR RECT RESECT NEC 

4864 POSTERIOR RECT RESECTION 

4865 DUHAMEL RECTAL RESECTION 

4866 HARTMANN RECT RESECTION 
4869 RECTAL RESECTION NEC 

4871 SUTURE OF RECTAL LACER 

4872 CLOSURE OF PROCTOSTOMY 

4873 CLOSE RECTAL FIST NEC 

4874 RECTORECTOSTOMY 

4875 ABDOMINAL PROCTOPEXY 

4876 PROCTOPEXY NEC 

4879 REPAIR OF RECTUM NEC 

4881 PERIRECTAL INCISION 

4882 PERIRECTAL EXCISION 

4891 INC IS RECTAL STRICTURE 

4892 ANORECTAL MYOMECTOMY 

4893 REPAIR PERIRECT FISTULA 
4899 RECTAL PERIRECT OP NEC 

4901 INCIS PERIANAL ABSCESS 

4902 PERIANAL INCISION NEC 
4904 PERIANAL EXCISION NEC 

4911 ANAL FISTULOTOMY 

4912 ANAL FISTULECTOMY 



Table 2.7— Continued 
ICD-9-CM operating room procedure codes 



493 LOC DESTR ANAL LES NEC 

4944 HEMORRHOID CRYOTHERAPY 

4945 HEMORRHOID LIGATION 

4946 HEMORRHOIDECTOMY 

4949 HEMORRHOID PROCEDURE NEC 

4951 LEFT LAT SPHINCTEROTOMY 

4952 POST SPHINCTEROTOMY 
4959 ANAL SPHINCTEROTOMY NEC 
496 EXCISION OF ANUS 

4971 SUTURE ANAL LACERATION 

49 72 ANAL CERCLAGE 

4973 CLOSURE OF ANAL FISTULA 

4974 GRACILIS MUSC TRANSPLAN 
49 79 ANAL SPHINCT REPAIR NEC 

4991 INCISION OF ANAL SEPTUM 

4992 INSERT SUBQ ANAL STIMUL 

4993 ANAL INCISION NEC 

4994 REDUCTION ANAL PROLAPSE 

4995 CONTROL ANAL HEMORRHAGE 
4999 ANAL OPERATION NEC 

500 HEPATOTOMY 

5012 LIVER BIOPSY NEC 

5019 HEPATIC DX PROC NEC 

5021 MARSUPIALIZAT LIVER LES 

5022 PARTIAL HEPATECTOMY 
5029 DESTRUC HEPATIC LES NEC 

503 HEPATIC LOBECTOMY 

504 TOTAL HEPATECTOMY 

5051 AUXILIARY LIVER TRANSPL 

5059 LIVER TRANSPLANT NEC 

5061 CLOSURE LIVER LACERAT 

5069 LIVER REPAIR NEC 

5102 TROCAR CHOLECYSTOSTOMY 

5103 CHOLECYSTOSTOMY NEC 

5104 CHOLECYSTOTOMY NEC 
5113 BILIARY TRACT BX NEC 
5119 BILIARY TR DX PROC NEC 

5121 PARTIAL CHOLECYSTECTOMY 

5122 TOTAL CHOLECYSTECTOMY 

5131 GB-TO-HEPAT DUCT ANAST 

5132 GB -TO- INTESTINE ANASTOM 

5133 GB -TO -PANCREAS ANASTOM 

5134 GB-TO-STOMACH ANASTOMOS 

5135 GALLBLADDER ANASTOM NEC 

5136 CHOLEDOCHOENTEROSTOMY 

5137 HEPATIC DUCT-GI ANASTOM 
5139 BILE DUCT ANASTOMOS NEC 

5141 CDE FOR CALCULUS REMOV 

5142 CDE FOR OBSTRUCTION NEC 

5143 CHOLEDOCHOHEPAT INTUBAT 
5149 INCIS OBSTR BILE DUC NEC 
5151 COMMON DUCT EXPLORATION 
5159 BILE DUCT INCISION NEC 
5161 EXCIS CYST DUCT REMNANT 



5162 EXCIS AMPULLA OF VATER 

5163 COMMON DUCT EXCIS NEC 
5169 BILE DUCT EXCISION NEC 

5171 SIMPLE SUT-COMMON DUCT 

5172 CHOLEDOCHOPLASTY 
5179 BILE DUCT REPAIR NEC 
5181 SPHINCTER OF ODDI DILAT 
5183 PANCREAT SPHINCTEROPLAS 
5189 SPHINCT OF ODDI OP NEC 

5191 REPAIR GB LACERATION 

5192 CLOSURE CHOLECYSTOSTOMY 

5193 CLOS BILIARY FISTUL NEC 

5194 REVIS BILE TRACT ANASTOM 

5195 REMOVE BILE DUCT PROSTH 

5196 PERC EXTRAC COM DUC CALC 
5199 BILIARY TRACT OP NEC 
5201 CATH DRAIN -PANCREAT CYST 
5209 PANCREATOTOMY NEC 

5212 PANCREATIC BIOPSY NEC 

5219 PANCREATIC DX PROC NEC 

522 LOCAL DESTR PANCREAT LES 

523 PANCREAT CYST MARSUPIALI 

524 INT DRAIN PANCREAT CYST 

5251 PROXIMAL PANCREATECTOMY 

5252 DISTAL PANCREATECTOMY 

5253 RAD SUBTOT PANCREATECTOM 
5259 PARTIAL PANCREATECT NEC 

526 TOTAL PANCREATECTOMY 

527 RAD PANCREAT ICODUODENECT 

5280 PANCREAT TRANSPLANT NOS 

5281 RE IMPLANT PANCREATIC TIS 

5282 PANCREATIC HOMOTRANSPLAN 

5283 PANCREATIC HETEROTRANSPL 

5292 OTH CANNULATION-PANC DCT 

5293 DILATION-WIRSUNG'S DUCT 

5294 WIRSUNG'S DUCT REPAIR 

5295 PANCREATIC REPAIR NEC 

5296 PANCREATIC ANASTOMOSIS 

5299 PANCREATIC OPERATION NEC 

5300 UN I LAT ING HERN REP NOS 

5301 REPAIR DIRECT ING HERNIA 

5302 REPAIR INDIR ING HERNIA 

5303 DIR ING HERNIA REP-GRAFT 

5304 IND ING HERNIA REP-GRAFT 

5305 ING HERNIA REP-GRAFT NOS 

5310 BILAT ING HERNIA REP NOS 

5311 BILAT DIR ING HERN REP 

5312 BILAT IND ING HERN REP 

5313 BIL DIR/IND ING HRN REP 

5314 BIL DIR ING HRN REP-GRFT 

5315 BIL IND ING HRN REP-GRFT 

5316 BIL DIR/IND ING HERN-PRO 

5317 BIL ING HRN REP-GRFT NOS 
5321 UNIL FEMOR HRN REP-GRFT 



28 



Table 2.7— Continued 
SCD-9-CM operating room procedure codes 



5329 UNIL FEMOR HERN REP NEC 

5331 BIL FEM HERN REPAIR-GRFT 

5339 BIL FEM HERN REPAIR NEC 

5341 UMBIL HERNIA REPAIR-GRFT 

5349 UMBIL HERNIA REPAIR NEC 

5351 INCISIONAL HERNIA REPAIR 

5359 ABD WALL HERN REPAIR NEC 

5361 INCIS HERNIA REPAIR-GRFT 

5369 ABD HERN REPAIR-GRFT NEC 

537 ABD REPAIR-DIAPHR HERNIA 

5380 THOR REP-DIAPH HERN NOS 

5381 DIAPHRAGMATIC PLICATION 

5382 PARASTERN HERNIA REPAIR 

539 OTHER HERNIA REPAIR 

540 ABDOMINAL WALL INCISION 

5411 EXPLORATORY LAPAROTOMY 

5412 REOPEN RECENT LAP SITE 
5419 LAPAROTOMY NEC 

5421 LAPAROSCOPY 

5422 ABDOMINAL WALL BIOPSY 

5423 PERITONEAL BIOPSY 
5429 ABD REGION DX PROC NEC 

543 DESTRUCT ABD WALL LESION 

544 DESTRUCT PERITONEAL TISS 

545 PERITONEAL ADHESIOLYSIS 

5461 RECLOSE POST OP DISRUPT 

5462 DELAYED CLOS ABD WOUND 

5463 ABD WALL SUTURE NEC 

5464 PERITONEAL SUTURE 

5471 REPAIR OF GASTROSCHISIS 

5472 ABDOMEN WALL REPAIR NEC 

5473 PERITONEAL REPAIR NEC 

5474 OMENTAL REPAIR NEC 

5475 MESENTERIC REPAIR NEC 

5492 REMOVE FB FROM PERITON 

5493 CREATE CUTANPERITON FIST 

5494 CREAT PERITONEOVAS SHUNT 

5495 PERITONEAL INCISION 
5499 ABDOMEN REGION OPS NEC 

5501 NEPHROTOMY 

5502 NEPHROSTOMY 

5511 PYELOTOMY 

5512 PYELOSTOMY 

5524 RENAL BIOPSY NEC 

5529 RENAL DIAGNOST PROC NEC 

5531 RENAL LES MARSUPIALIZAT 

5539 LOC DESTR RENAL LES NEC 

554 PARTIAL NEPHRECTOMY 

5551 NEPHROURETERECTOMY 

5552 SOLITARY KIDNEY NEPHRECT 

5553 REJECTED KIDNEY NEPHRECT 

5554 BILATERAL NEPHRECTOMY 
5561 RENAL AUTOTRANS PLANT 
5569 KIDNEY TRANSPLANT NEC 



557 NEPHROPEXY 

5581 SUTURE KIDNEY LACERATION 

5582 CLOSE NEPHROST PYELOST 

5583 CLOSE RENAL FISTULA NEC 

5584 REDUCE RENAL PEDICL TORS 

5585 SYMPHYSIOTOMY 

5586 RENAL ANASTOMOSIS 

5587 CORRECT URETEROPELV JUNC 
5589 RENAL REPAIR NEC 

5591 RENAL DECAPSULATION 

559 7 IMPLANT MECHANIC KIDNEY 

5598 REMOV MECHANICAL KIDNEY 

5599 RENAL OPERATION NEC 

560 TU REMOV URETER OBSTRUCT 

561 URETERAL MEATOTOMY 

562 URETEROTOMY 

5633 URETERAL BIOPSY NEC 

5639 URETERAL DX PROCEDUR NEC 

5640 URETERECTOMY NOS 

5641 PARTIAL URETERECTOMY 

5642 TOTAL URETERECTOMY 

5651 FORM CUTAN lLEOURETEROST 

5652 REVIS CUTAN ILEOURETEROS 

5661 FORM CUTAN URETEROSTOMY 

5662 REVIS CUTAN URETEROS NEC 

5671 URIN DIVERSION TO BOWEL 

5672 REVIS URETEROENTEROSTOMY 
567 3 NEPHROCYSTANASTOMOSI NOS 

5674 URETERONEOCYSTOSTOMY 

5675 TRANSURETEROURETEROSTOMY 
5679 URETERAL ANASTOMOSIS NEC 

5681 INTRALUM URETE ADHESIOLY 

5682 SUTURE URETERAL LACERAT 

5683 URETEROSTOMY CLOSURE 

5684 CLOSE URETER FISTULA NEC 

5685 URETEROPEXY 

5686 REMOVE URETERAL LIGATURE 
5689 REPAIR OF URETER NEC 

5692 IMPLANT URETERAL STIMUL 

5693 REPLACE URETERAL STIMUL 

5694 REMOVE URETERAL STIMULAT 

5695 LIGATION OF URETER 
5699 URETERAL OPERATION NEC 
5712 CYSTOTOMY ADHESIOLYSIS 

5721 FORMATION OF CYSTOSTOMY 

5722 REVISION OF CYSTOSTOMY 

5733 TRANSURETH BLADD BIOPSY 

5734 BLADDER BIOPSY NEC 

5739 BLADDER DIAGNOS PROC NEC 

5741 TU ADHESIOLYSIS BLADDER 

5 749 TU DESTRUC BLADD LES NEC 

5751 EXCISION OF URACHUS 

5759 BLADDER LES DESTRUCT NEC 

5 76 PARTIAL CYSTECTOMY 



Table 2.7— Continued 
ICD-9-CM operating room procedure codes 



57 71 RADICAL CYSTECTOMY 

5779 TOTAL CYSTECTOMY NEC 

5 781 SUTURE BLADDER LACE RAT 

5782 CYSTOSTOMY CLOSURE 

5783 ENTEROVESICO FIST REPAIR 

5784 VESIC FISTULA REPAIR NEC 

5785 CYSTOURETHROPLASTY 

5786 BLADDER EXSTROPHY REPAIR 

5787 BLADDER RECONSTRUCTION 
5 788 BLADDER ANASTOMOSIS NEC 
5789 BLADDER REPAIR NEC 

5 791 BLADDER SPHINCTEROTOMY 

5793 CONTROL BLADD HEMORRHAGE 

5 796 IMPLANT BLADDER STIMULAT 

5 79 7 REPLACE BLADDER STIMULAT 

5798 REMOVE BLADDER STIMULAT 

5799 BLADDER OPERATION NEC 

580 URETHROTOMY 

581 URETHRAL MEATOTOMY 

5841 SUTURE URETHRAL LACERAT 

5842 URETHROSTOMY CLOSURE 

5843 CLOSE URETH FISTULA NEC 

5844 URETHRAL REANASTOMOSIS 

5845 HYPO-EPISPADIUS REPAIR 

5846 URETH RECONSTRUCTION NEC 

5847 URETHRAL MEATOPLASTY 
5849 URETHRAL REPAIR NEC 

5 85 URETH STRICTURE RELEASE 

5891 PERIURETHRAL INCISION 

5892 PERIURETHRAL EXCISION 

5899 URETH/ PER IURETH OP NEC 

5900 RETROPERIT DISSECT NOS 

5901 URETEROLYS FCR FIBROSIS 

5902 PERIREN ADHESIOLYS NEC 
5909 PERIREN/URETER INCIS NEC 
5911 PERIVESICAL ADHESIOLYSIS 
5919 PERIVESICAL INCISION NEC 
5921 PERIREN/URETERAL BIOPSY 
5929 PERIREN/URET DX PROC NEC 
59 3 URETHROVES JUNCT PLICAT 

594 SUPRAPUBIC SLING OP 

595 RETROPUBIC URETH SUSPENS 

596 PARAURETHRAL SUSPENSION 
59 71 LEVATOR MUSC SUSPENSION 
5979 URIN INCONTIN REPAIR NEC 

5991 PERIREN/VES ICLE EXCISION 

5992 PERIREN/VES ICLE OP NEC 
600 INCISION OF PROSTATE 
6012 PROSTATIC BIOPSY NEC 

6014 SEMINAL VES BIOPSY NEC 

6015 PERIPROSTATIC BIOPSY 

6018 pro; vric dx proced nec 

6019 SEM1N VES DX PROCED NEC 
602 TRANSURETHRAL PROSTATECT 



603 SUPRAPUBIC PROSTATECTOMY 

604 RETROPUBIC PROSTATECTOMY 

605 RADICAL PROSTATECTOMY 

6061 LOS EXCIS PROSTATIC LES 

6062 PERINEAL PROSTATECTOMY 
6069 PROSTATECTOMY NEC 

6072 SEMINAL VESICLE INCISION 

6073 SEMINAL VESICLE EXCISION 
6079 SEMINAL VESICLE OP NEC 

6081 PERIPROSTATIC INCISION 

6082 PERIPROSTATIC EXCISION 

6093 REPAIR OF PROSTATE 

6094 CONTROL POSTOP PROST HEM 
6099 PROSTATIC OPERATION NEC 
612 EXCISION OF HYDROCELE 
6142 SCROTAL FISTULA REPAIR 
6149 SCROTUM/TUNIC REPAIR NEC 
6192 EXCISION TUNICA LES NEC 
6199 SCROTUM TUNICA OP NEC 
620 INCISION OF TESTES 

6212 TESTICULAR BIOPSY NEC 

6219 TESTES DX PROCEDURE NEC 

622 TESTICULAR LES DESTRUCT 

623 UNILATERAL ORCHIECTOMY 

6241 REMOVE BOTH TESTES 

6242 REMOVE SOLITARY TESTIS 
625 ORCHIOPEXY 

6261 SUTURE TESTICULAR LACER 

6269 TESTICULAR REPAIR NEC 

627 INSERT TESTICULAR PROSTH 

6299 TESTICULAR OPERATION NEC 

6309 SPERMAT CORD/VAS DX NEC 

631 EXC SPERMATIC VARICOCELE 

632 EXCISE EPIDIDYMIS CYST 

633 EXCISE CORD/EPID LES NEC 

634 EPIDIDYMECTOMY 

6351 SUTURE CORD EPID LACER 

6353 TRANSPLANT SPERMAT CORD 

6359 CORD EPIDID REPAIR NEC 

6381 SUTURE VAS EPIDID LAC 

6382 POSTOP VAS RECONSTRUCT 

6383 EPIDIDYMOVASOSTOMY 

6385 REMOV VAS DEFERENS VALVE 

6389 VAS EPIDIDY REPAIR NEC 

6392 EPIDIDYMOTOMY 

6393 SPERMATIC CORD INCISION 

6394 SPERM CORD ADHESIOLYSIS 

6395 INSERT VALVE IN VAS DEF 
6399 CORD/EPID/VAS OPS NEC 
640 CIRCUMCISION 

6411 PENILE BIOPSY 

642 LOCAL EXCIS PENILE LES 

643 AMPUTATION OF PENIS 
6441 SUTURE PENILE LACERATION 



30 



Table 2.7— Continued 
ICD-9-CM operating room procedure codes 



6442 RELEASE OF CHORDEE 

6443 CONSTRUCTION OF PENIS 

6444 RECONSTRUCTION OF PENIS 

6445 REPLANTATION OF PENIS 
6449 PENILE REPAIR NEC 

645 SEX TRANSFORMAT OP NEC 

6492 INCISION OF PENIS 

6493 DIVISION OF PENILE ADHES 

6495 INSERT INT PENILE PROSTH 

6496 REMOVE INT PENILE PROSTH 

6498 PENILE OPERATION NEC 

6499 MALE GENITAL OP NEC 
650 OOPHOROTOMY 

6511 OVARIAN ASPIRAT BIOPSY 

6512 OVARIAN BIOPSY NEC 

6519 OVARIAN DX PROCEDURE NEC 

6521 OVARIAN CYST MARSUPIALIZ 

6522 OVARIAN WEDGE RESECTION 
6529 LOCAL DESTR OVA LES NEC 

653 UNILATERAL OOPHORECTOMY 

654 UNILAT SALPINGO-OOPHOREC 

6551 REMOVE BOTH OVARIES 

6552 REMOVE SOLITARY OVARY 

6561 REMOVE BOTH TUBES OVAR 

6562 REMOVE SOLITARY TUBE/OVA 

6571 SIMPLE SUTURE OF OVARY 

6572 OVARIAN REIMPLANTATION 

6573 SALPINGO -OOPHOROPLASTY 
6579 REPAIR OF OVARY NEC 
658 TUBO-OVARIAN ADHES IOLYS 

6591 ASPIRATION OF OVARY 

6592 TRANSPLANTATION OF OVARY 

6593 MANUAL RUPT OVARIAN CYST 

6594 OVARIAN DENERVATION 

6595 OVARIAN TORSION RELEASE 
6599 OVARIAN OPERATION NEC 
660 SALPINGOTOMY 

6611 FALLOPIAN TUBE BIOPSY 

6619 FALLOP TUBE DX PROC NEC 

6621 BILAT ENDOSC CRUSH TUBE 

6622 BILAT ENDOSC DIVIS TUBE 
6629 BILAT ENDOS OCC TUBE NEC 

6631 BILAT TUBAL CRUSHING NEC 

6632 BILAT TUBAL DIVISION NEC 
6639 BILAT TUBAL DESTRUCT NEC 
664 TOTAL UNILAT SALPINGECT 

6651 REMOVE BOTH FALLOP TUBES 

6652 REMOVE SOLITARY FAL TUBE 

6661 DESTROY FALLOP TUBE LES 

6662 REMOV TUBE ECTOP PREG 

6663 BILAT PART SALPINGEC NOS 
6669 PARTIAL SALPINGECTOM NEC 

6671 SIMPL SUTURE FALLOP TUBE 

6672 SALPINGO-OOPHOROSTOMY 



6673 SALPINGO-SALPINGOSTOMY 

6674 SALPINGO-UTEROSTOMY 
6679 FALLOP TUBE REPAIR NEC 

6692 UNILAT FALLOP TUBE DESTR 

6693 IMPL FALLOP TUBE PROSTH 

6694 REMOV FALLOP TUBE PROSTH 

6695 BLOW THERAPEUT INTO TUBE 

6696 FALLOPIAN TUBE DILATION 
669 7 BURY FIMBRIAE IN UTERUS 
6699 FALLOPIAN TUBE OP NEC 

6711 ENDOCERVICAL BIOPSY 

6712 CERVICAL BIOPSY NEC 
6719 CERVICAL DX PROCEDUR NEC 
672 CONIZATION OF CERVIX 

6731 CERVICAL CYST MARSUPIAL 

6732 CERVICAL LES CAUTERIZAT 

6733 CERVICAL LES CRYOTHERAPY 
6739 CERVICAL LES DESTRUC NEC 

674 AMPUTATION OF CERVIX 

675 INT CERVICAL OS REPAIR 

6761 SUTURE CERVICAL LACERAT 

6762 CERVICAL FISTULA REPAIR 
6769 CERVICAL REPAIR NEC 

680 HYSTEROTOMY 

6814 UTERINE LIGAMENT BIOPSY 

6819 UTERUS/ADNEX DX PROC NEC 

6821 ENDOMET SYNECHIAE DIVIS 

6822 INCISION UTERINE SEPTUM 
6829 UTERINE LES DESTRUCT NEC 

683 SUBTOT ABD HYSTERECTOMY 

684 TOTAL ABD HYSTERECTOMY 

685 VAGINAL HYSTERECTOMY 

686 RADICAL ABD HYSTERECTOMY 

687 RADICAL VAG HYSTERECTOMY 

688 PELVIC EVISCERATION 

6901 D C FOR PREG TERMINAT 

6902 D C POST DELIVERY 
6909 D C NEC 

6911 REMOVE INTRALIG ECT PREG 

6919 DESTRUC UTER SUPPORT NEC 

6921 INTERPOSIT OP UTERIN LIG 

6922 UTERINE SUSPENSION NEC 

6923 VAG REPAIR INVERS UTERUS 
6929 UTERUS/ADNEXA REPAIR NEC 
693 PARACERV UTERINE DENERV 

6941 SUTURE UTERINE LACERAT 

6942 CLOSURE UTERINE FISTULA 
6949 UTERINE REPAIR SEC 

6951 ASPIRAT CURET-PREG TERMI 

6995 INCISION OF CERVIX 

699 7 REMOVE PENETRAT CERV FB 

6998 UTERINE SUPPORT OP NEC 

6999 UTERINE OPERATION NEC 
7012 CULDOTOMY 



31 



Table 2.7— Continued 
ICD-9-CM operating room procedure codes 



7013 INTRALUM VAG ADHESIOLYS 

7014 VAGINOTOMY NEC 

7023 CUL-DE-SAC BIOPSY 

7024 VAGINAL BIOPSY 

7029 VAGIN/CUL-DE-SAC DX NEC 

7031 HYMENECTOMY 

7032 EXCIS CUL-DE-SAC LESION 

7033 EXCISION VAGINAL LESION 
704 VAGINAL OBLITERATION 

7050 CYSTOCEL/RECTOCEL REPAIR 

7051 CYSTOCELE REPAIR 

7052 RECTOCELE REPAIR 

7061 VAGINAL CONSTRUCTION 

7062 VAGINAL RECONSTRUCTION 

7071 SUTURE VAGINA LACERATION 

7072 REPAIR COLOVAGIN FISTULA 

7073 REPAIR RECTOVAG FISTULA 

7074 REP VAGINOENT FISTUL NEC 

7075 REPAIR VAG FISTULA NEC 
7077 VAGINAL SUSPENS FIXAT 
7079 VAGINAL REPAIR NEC 

708 VAGINAL VAULT OBLITERAT 

7091 VAGINAL OPERATION NEC 

7092 CUL-DE-SAC OPERATION NEC 
7101 VULVAR ADHESIOLYSIS 
7109 INCIS VULVA/PERINEUM NEC 
7111 VULVAR BIOPSY 

7119 VULVAR DIAGNOS PROC NEC 

7122 INCISE BARTHOLIN'S GLAND 

7123 BARTHOLIN GLAND MARSUP 

7124 DESTRUC BARTHOLIN GLAND 
7129 BARTHOLIN'S GLAND OP NEC 

713 LOCAL VULVAR EXCIS NEC 

714 OPERATIONS ON CLITORIS 

715 RADICAL VULVECTOMY 

7161 UNILATERAL VULVECTOMY 

7162 BILATERAL VULVECTOMY 

7171 SUTURE VULVAR LACERATION 

7172 REPAIR VULVAR FISTULA 
7179 VULVAR/PERIN REPAIR NEC 

718 OTHER VULVAR OPERATIONS 

719 OTHER FEMALE GENITAL OPS 
7394 PUBIOTOMY TO ASSIST DEL 
7399 OPS ASSISTING DELIV NEC 

740 CLASSICAL C-SECTION 

741 LOW CERVICAL C-SECTION 

742 EXTRAPERITONEAL C-SECT 

743 REMOV INTRAPERIT FETUS 

744 CESAREAN SECTION NEC 
7491 HYSTEROTOMY TO TERMIN PG 
7499 CESAREAN SECTION NOS 
7536 CORRECTION FETAL DEFECT 

7550 REPAIR OB LAC UTERUS NOS 

7551 REPAIR OB LACERAT CERVIX 



7552 REPAIR OB LAC CORP UTERI 

7561 REPAIR OB LAC BLAD/URETH 

7593 SURG CORR INVERT UTERUS 

7599 OBSTETRIC OPERATION NEC 

7601 FACIAL BONE SEQUESTRECT 

7609 FACIAL BONE INCISION NEC 

7611 FACIAL BONE BIOPSY 

7619 FACIAL BONE DX PROC NEC 

762 DESTRUCT FACIAL BONE LES 

7631 PARTIAL MANDIBULECTOMY 

7639 PART FACIAL OSTECTOM NEC 

7641 TOT MANDIBULEC W RECONST 

7642 TOTAL MANDIBULECTOMY NEC 

7643 MANDIBULAR RECONST NEC 

7644 TOT FACE OSTECT W RECONS 

7645 TOT FACE BONE OSTECT NEC 

7646 FACIAL BONE RECONSTR NEC 
765 TEMPOROMAND ARTHROPLASTY 

7661 CL OSTEOPLASTY MAND RAMI 

7662 OPEN OSTEOPLAS MAND RAMI 

7663 OSTEOPLASTY MANDIBLE BDY 

7664 MAND ORTHOGNATHIC OP NEC 

7665 SEG OSTEOPLASTY MAXILLA 

7666 TOT OSTEOPLASTY MAXILLA 

7667 REDUCTION GENIOPLASTY 

7668 AUGMENTATION GENIOPLASTY 

7669 FACIAL BONE REPAIR NEC 

7670 REDUCTION FACIAL FX NOS 
7672 OPN REDUCT MALAR/ZYGO FX 
7674 OPEN REDUCT MAXILLARY FX 

7676 OPEN REDUCT MANDIBLE FX 

7677 OPEN REDUCT ALVEOLAR FX 
7679 OPEN REDUCT FACE FX NEC 

7691 BONE GRAFT TO FACE BONE 

7692 SYN IMPLANT TO FACE BONE 
7694 OPEN REDUCT TM DISLOCAT 
769 7 REMOVE INT FIX FACE BONE 

7699 FACIAL BONE/JNT OP NEC 

7700 SEQUESTRECTOMY NOS 

7 701 CHEST CAGE SEQUESTREC 

7702 HUMERUS SEQUESTRECTOMY 

7703 RADIUS ULNA SEQUESTREC 
7 704 METACARP/CARP SEQUESTREC 

7705 FEMORAL SEQUESTRECTOMY 

7706 PATELLAR SEQUESTRECTOMY 

7707 TIBIA/FIBULA SEQUESTREC 
7 708 METATAR/TAR SEQUESTREC 

7 709 SEQUESTRECTOMY NEC 

7710 OTHER BONE INCISION NOS 

7711 OTHER CHEST CAGE INCIS 

7712 OTHER HUMERUS INCISION 

7713 OTHER RADIUS/ULNA INCIS 
7 714 OTH METACARP/CARP INCIS 
7715 OTHER FEMORAL INCISION 



32 



Table 2.7— Continued 
ICD-9-CM operating room procedure codes 



7716 OTHER PATELLAR INCISION 

7717 OTHER TIBIA/FIBULA INCIS 

7718 OTH METATARS/TARS INCIS 

7719 BONE INCIS W/0 DIV NEC 

7720 WEDGE OSTEOTOMY NOS 

7721 CHEST CAGE WEDG OSTEOTOM 

7722 HUMERUS WEDGE OSTEOTOMY 

7723 RADIUS /ULNA WEDG OSTEOTO 

7724 METACAR/CAR WEDG OSTEOTO 

7725 FEMORAL WEDGE OSTEOTOMY 

7726 PATELLAR WEDGE OSTEOTOMY 

7727 TIBIA/FIBUL WEDG OSTEOT 
7 728 METATAR/TAR WEDG OSTEOT 

7729 WEDGE OSTEOTOMY NEC 

7730 OTHER BONE DIVISION NOS 

7731 CHEST CAGE BONE DIV NEC 

7732 HUMERUS DIVISION NEC 

7733 RADIUS/ULNA DIVISION NEC 

7734 METACAR/CAR DIVISION NEC 

7735 FEMORAL DIVISION NEC 

7736 PATELLAR DIVISION NEC 

7737 TIBIA/FIBULA DIV NEC 

7738 METATAR/TAR DIVISION NEC 

7739 BONE DIVISION NEC 

7740 BONE BIOPSY NOS 

7741 CHEST CAGE BONE BIOPSY 

7742 HUMERUS BIOPSY 

7743 RADIUS ULNA BIOPSY 

7 744 METACARPAL/CARPAL BIOPSY 

7745 FEMORAL BIOPSY 

7 746 PATELLAR BIOPSY 

7747 TIBIA FIBULA BIOPSY 

7748 METATARSAL/TARSAL BIOPSY 

7749 BONE BIOPSY NEC 

7751 BUNIONECT/SFT/OSTEOTOMY 

7 752 BUNIONECT/SFT/ARTHRODES 

7753 OTH BUNIONECT W SFT CORR 

7754 EXCISION OF BUNIONETTE 

7759 BUNIONECTOMY NEC 

7760 LOC EXC BONE LESION NOS 
7 761 EXC CHEST CAGE BONE LES 

7 762 LOC EXC BONE LES HUMERUS 

7 763 LOC EXC LES RADIUS/ULNA 

7 764 LOC EXC LES METACAR/CAR 

7765 LOC EXC BONE LES FEMUR 

7 766 LOC EXC BONE LES PATELLA 

7767 LOC EXC LES TIBIA/FIBULA 

7 768 LOC EXC LES METATAR/TAR 

7769 LOC EXC BONE LESION NEC 

7770 EXCISE BONE FOR GRFT NOS 

7771 EX CHEST CAGE BONE-GFT 

7772 EXCISE HUMERUS FOR GRAFT 

7773 EXCIS RADIUS /ULNA -GRAFT 

7774 EXCIS METACAR/CAR-GRAFT 



7775 EXCISE FEMUR FOR GRAFT 

7776 EXCISE PATELLA FOR GRAFT 

7777 EXCISE TIB/FIB FOR GRAFT 

7778 EXCIS METATAR/TAR -GRAFT 

7779 EXCISE BONE FOR GFT NEC 
7 780 OTH PART OSTEOTOMY NOS 

7781 OTH CHEST CAGE OSTEOTOMY 

7782 PARTIAL HUMERECTOMY NEC 

7783 PART OSTECT-RADIUS/ULNA 

7784 PART OSTECT- METACAR/CAR 

7785 PART OSTECTOMY-FEMUR 

7786 PARTIAL PATELLECTOMY 

7787 PART OSTECT -TIBIA/FIBULA 
7 788 PART OSTECT-METATAR/TAR 

7 789 PARTIAL OSTEOTOMY NEC 

7790 TOTAL OSTEOTOMY NOS 

7791 TOT CHEST CAGE OSTECTOMY 
7 792 TOTAL OSTECTOMY-HUMERUS 

7793 TOT OSTECT-RADIUS/ULNA 

7794 TOT OSTECT-METACARP/CARP 
7 795 TOT OSTECTOMY-FEMUR 

7796 TOTAL PATELLECTOMY 

7797 TOT OSTECT -TIBIA/FIBULA 

7798 TOT OSTECT -METATARS/TARS 

7799 TOTAL OSTECTOMY NEC 

7800 BONE GRAFT NOS 

7801 BONE GRAFT TO CHEST CAGE 

7802 BONE GRAFT TO HUMERUS 

7803 BONE GRAFT -RADIUS /ULNA 

7804 BONE GRFT TO METACAR/CAR 

7805 BONE GRAFT TO FEMUR 

7806 BONE GRAFT TO PATELLA 

7807 BONE GRAFT-TIBIA/FIBULA 

7808 BONE GRAFT -METATAR/TAR 

7809 BONE GRAFT NEC 

7810 PERIOSTEAL SUTURE NOS 

7811 PERIOST SUT-CHEST CAGE 

7812 PERIOSTEAL SUT-HUMERUS 

7813 PERIOST SUT-RADIUS/ULNA 

7814 PERIOST SUT- METACAR/CAR 

7815 PERIOSTEAL SUTURE -FEMUR 

7816 PERIOSTEAL SUTUR-PATELLA 

7817 PERIOST SUT-TIBIA/FIBULA 

7818 PERIOST SUT-METATAR/TAR 

7819 PERIOSTEAL SUTURE NEC 

7820 EPIPHYSEAL STAPLING NOS 

7822 EPIPHYS STAPLE -HUMERUS 

7823 EPIPHYS STAPLE -RAD/ULNA 
7825 EPIPHYSEAL STAPLE-FEMUR 
7827 EPIPHYS STAPLE -TIB/FIBUL 

7829 EPIPHYSEAL STAPLING NEC 

7830 OTH BONE LNGTH CHNGE NOS 

7831 BONE LNGTH CHNGE -THORAX 

7832 HUMERUS LENGTH CHANGE 



Table 2.7— Continued 
ICD-9-CM operating room procedure codes 



7833 RADIUS/ULNA LENGTH CHNGE 

7834 CARPAL LENGTH CHANGE 

7835 FEMUR LENGTH CHANGE 

7837 TIBIA/FIBULA LNGTH CHNGE 

7838 TARSAL LENGTH CHANGE 

7839 OTH BONE LNGTH CHNGE NEC 

7840 OTHER BONE REPAIR NOS 

7841 OTHER CHEST CAGE REPAIR 

7842 OTHER HUMERUS REPAIR 

7843 OTHER RADIUS/ULNA REPAIR 

7844 OTHER METACAR/CAR REPAIR 

7845 OTHER REPAIR-FEMUR 

7846 OTHER PATELLAR REPAIR 

7847 OTH TIBIA/FIBULA REPAIR 

7848 OTHER METATAR/TAR REPAIR 

7849 OTHER BONE REPAIR NEC 

7850 INT FIX W/O FX REDUC NOS 

7851 INT FIXATION-CHEST CAGE 

7852 INT FIXATION -HUMERUS 

7853 INT FIXATION-RADIUS/ULNA 

7854 INT FIXATION -METACAR/CAR 

7855 INTERNAL FIXATION-FEMUR 

7856 INTERNAL FIX-PATELLA 

7857 INT FIXATION-TIBIA/FIBUL 

7858 INT F IXAT I ON - METATAR/TAR 

7859 INT FIX-NO FX REDUCT NEC 

7860 REMOVE INT FIX DEVIC NOS 

7861 REMOV INT FIX-CHEST CAGE 

7862 REMOVE INT FIX-HUMERUS 

7863 REMOV INT FIX-RADIUS/ULN 

7864 REMOV INT FIX-METAC/CARP 

7865 REMOVE INT FIX DEV-FEMUR 

7866 REMOVE INT FIX-PATELLA 

7867 REMOV INT FIX-TIB/FIBULA 

7868 REMOV INT FIX-METAT/TAR 

7869 REMOVE INT FIX DEVIC NEC 

7870 OSTEOCLASIS NOS 

7871 OSTEOCLASIS-CHEST CAGE 

7872 OSTEOCLASIS-HUMERUS 

7873 OSTEOCLASIS-RADIUS/ULNA 

7874 OSTEOCLASIS -METACAR/CAR 

7875 OSTEOCLASIS-FEMUR 

7876 OSTEOCLASIS -PATELLA 

7877 OSTEOCLAS1S-TIBIA/FIBULA 

7878 OSTEOCLASIS -METATAR/TAR 

7879 OSTEOCLASIS NEC 

7880 OTHER BONE DX PROC NuS 

7881 OTH DX PROCED-CHEST CAGE 

7882 OTH DX PROCED -HUMERUS 

7883 OTH DX PROC -RADIUS/ULNA 

7884 OTH DX PROC-METACAR/CAR 

7885 OTH DX PROCED-FEMUR 

7886 OTH DX PROCED -PATELLA 

7887 OTH DX PROC-TIBIA/FIBULA 



7888 OTH DX PROC -METATAR/TAR 

7889 OTHER BONE DX PROC NEC 

7890 OTHER BONE OPERATION NOS 

7891 OTH BONE OPS-CHEST CAGE 

7892 OTHER OPS ON HUMERUS 

7893 OTHER OPS ON RADIUS/ULNA 

7894 OTHER OPS ON METACAR/CAR 

7895 OTHER OPS ON FEMUR 

7896 OTHER OPS ON PATELLA 

7897 OTHER OPS ON TIBIA/FIBUL 

7898 OTHER OPS ON METATAR/TAR 

7899 OTHER BONE OPERATION NEC 

7910 CL FX REDUC-INT FIX NOS 

7911 CLOS RED-INT FIX HUMERUS 

7912 CL RED- INT FIX RAD/ULNA 

7913 CL RED- INT FIX METAC/CAR 

7914 CLOSE RED-INT FIX FINGER 

7915 CLOSED RED- INT FIX FEMUR 

7916 CL RED-INT FIX TIB/FIBU 

7917 CL RED- INT FIX METAT/TAR 

7918 CLOSE RED- INT FIX TOE FX 

7919 CL FX REDUC-INT FIX NEC 

7920 OPEN FX REDUCTION NOS 

7921 OPEN REDUC -HUMERUS FX 

7922 OPEN REDUC-RADIUS/ULN FX 

7923 OPEN REDUC -METAC/CAR FX 

7924 OPEN REDUCTION-FINGER FX 

7925 OPEN REDUCTION-FEMUR FX 

7926 OPEN REDUC -TIBIA/FIB FX 

7927 OPEN REDUC -METAT/TARS FX 

7928 OPEN REDUCTION-TOE FX 

7929 OPEN FX REDUCTION NEC 

7930 OPN FX RED W INT FIX NOS 

7931 OPEN RED- INT FIX HUMERUS 

7932 OP RED-INT FIX RAD/ULNA 

7933 OP RED- INT FIX METAC/CAR 

7934 OPEN RED-INT FIX FINGER 

7935 OPEN REDUC-INT FIX FEMUR 

7936 OP RED-INT FIX TIB/FIBUL 

7937 OP RED-INT FIX METAT/TAR 

7938 OPEN REDUCT-INT FIX TOE 

7939 OPN FX RED W INT FIX NEC 

7940 CLS REDUC-SEP EPIPHY NOS 

7941 CLOSE RED-HUMERUS EPIPHY 

7942 CLS RED-RADIUS/UL EPIPHY 

7945 CLOSE REDUC-FEMUR EPIPHY 

7946 CLS RED-TIBIA/FIB EPIPHY 

7949 CLS REDUC-SEP EPIPHY NEC 

7950 OPEN RED-SEP EPIPHY NOS 

7951 OPN RED-SEP EPIPHY-HUMER 

7952 OP RED-RADIUS/ULN EPIPHY 

7955 OPN RED-SEP EPIPHY-FEMUR 

7956 OP RED-TIBIA/FIB EPIPHYS 
7959 OPEN RED-SEP EPIPHY NEC 



Table 2.7— Continued 
ICD-9-CM operating room procedure codes 



7960 OPEN FX SITE DEBRIDE NOS 

7961 DEBRID OPEN FX-HUMERUS 

7962 DEBRID OPN FX-RADIUS/ULN 

7963 DEBRID OPN FX-METAC/CAR 

7964 DEBRID OPN FX-FINGER 

7965 DEBRID OPN FX-FEMUR 

7966 DEBRID OPN FX-TIBIA/FIB 

7967 DEBRID OPN FX-METAT/TAR 

7968 DEBRID OPN FX-TOE 

7969 OPEN FX SITE DEBRIDE NEC 

7980 OPEN REDUC-DISLOCAT NOS 

7981 OPN REDUC DISLOC-SHOULDR 

7982 OPEN REDUC -ELBOW DISLOC 

7983 OPEN REDUC -WRIST DISLOC 

7984 OPN REDUC DISLOC-HAND 

7985 OPEN REDUC-HIP DISLOCAT 

7986 OPEN REDUC-KNEE DISLOCAT 

7987 OPEN REDUC -ANKLE DISLOC 

7988 OPN REDUC DISLOC-FT/TOE 

7989 OPEN REDUC-DISLOCAT NEC 

7990 UNSPEC OP BONE INJ NOS 

7991 HUMERUS INJURY OP NOS 

7992 RADIUS/ULNA INJ OP NOS 

7993 METACARP/CARP INJ OP NOS 

7994 FINGER INJURY OP NOS 

7995 FEMUR INJURY OP NOS 

7996 TIBIA/FIBULA INJ OP NOS 

7997 METATARS/TARS INJ OP NOS 

7998 TOE INJURY OPERATION NOS 

7999 UNSPEC OP-BONE INJ NEC 

8000 ARTHROT PROS REMOV NOS 

8001 ARTHROT/PROS REMOV -SHLDR 

8002 ARTHROT/PROS REMOV-ELBOW 

8003 ARTHROT/PROS REMOV-WRIST 

8004 ARTHROT/PROS REMOV-HAND 

8005 ARTHROT/PROS REMOV-HIP 

8006 ARTHROT/PROS REMOV-KNEE 

8007 ARTHROT/PROS REMOV-ANKLE 

8008 ARTHROT/PROS REMOV-FOOT 

8009 ARTHROT PROS REMOV NEC 

8010 OTHER ARTHROTOMY NOS 

8011 OTH ARTHROTOMY-SHOULDER 

8012 OTH ARTHROTOMY-ELBOW 

8013 OTH ARTHROTOMY -WRIST 

8014 OTH ARTHROTOMY-HAND/FNGR 

8015 OTH ARTHROTOMY -HIP 

8016 OTH ARTHROTOMY -KNEE 

8017 OTH ARTHROTOMY -ANKLE 

8018 OTH ARTHROTOMY -FOOT /TOE 

8019 OTHER ARTHROTOMY NEC 

8020 ARTHROSCOPY NOS 

8021 SHOULDER ARTHROSCOPY 

8022 ELBOW ARTHROSCOPY 

8023 WRIST ARTHROSCOPY 



8024 HAND FINGER ARTHROSCOP 

8025 HIP ARTHROSCOPY 

8026 KNEE ARTHROSCOPY 

8027 ANKLE ARTHROSCOPY 

8028 FOOT TOE ARTHROSCOPY 

8029 ARTHROSCOPY NEC 

8040 JT STRUCTUR DIVISION NOS 

8041 SHOULDER STRUCT DIVISION 

8042 ELBOW STRUCTURE DIVISION 

8043 WRIST STRUCTURE DIVISION 

8044 HAND JOINT STRUCT DIVIS 

8045 HIP STRUCTURE DIVISION 

8046 KNEE STRUCTURE DIVISION 

8047 ANKLE STRUCTURE DIVISION 

8048 FOOT JOINT STRUCT DIVIS 

8049 JT STRUCTUR DIVISION NEC 

805 IV DISC EXCIS/DESTRUCT 

806 EXCIS KNEE SEMILUN CARTL 

8070 SYNOVECTOMY-SITE NOS 

8071 SHOULDER SYNOVECTOMY 

8072 ELBOW SYNOVECTOMY 

8073 WRIST SYNOVECTOMY 

8074 HAND SYNOVECTOMY 

8075 HIP SYNOVECTOMY 

8076 KNEE SYNOVECTOMY 

8077 ANKLE SYNOVECTOMY 

8078 FOOT SYNOVECTOMY 

8079 SYNOVECTOMY-SITE NEC 

8080 DESTRUCT JOINT LES NOS 

8081 DESTRUC- SHOULDER LES NEC 

8082 DESTRUC-ELBOW LESION NEC 

8083 DESTRUC-WRIST LESION NEC 

8084 DESTRUC -HAND JT LES NEC 

8085 DESTRUCT-HIP LESION NEC 

8086 DESTRUCT-KNEE LESION NEC 

8087 DESTRUC -ANKLE LESION NEC 

8088 DESTRUC -FOOT JT LES NEC 

8089 DESTRUCT JOINT LES NEC 

8090 EXCISION OF JOINT NOS 

8091 EXCISION OF SHOULDER NEC 

8092 EXCISION OF ELBOW NEC 

8093 EXCISION OF WRIST NEC 

8094 EXCISION HAND JOINT NEC 

8095 EXCISION OF HIP NEC 

8096 EXCISION OF KNEE NEC 

8097 EXCISION OF ANKLE NEC 

8098 EXCISION FOOT JOINT NEC 

8099 EXCISION OF JOINT NEC 

8100 SPINAL FUSION NOS 

8101 ATLAS -AXIS FUSION 

8102 OTHER CERVICAL FUSION 

8103 DORSAL SPINAL FUSION 

8104 DORSOLUMBAR FUSION W ROD 

8105 OTHER DORSOLUMBAR FUSION 



Table 2.7— Continued 
ICD-9-CM operating room procedure codes 



8106 LUMBAR SPINAL FUSION 

8107 LUMBOSACRAL FUSION 

8108 REFUSION OF SPINE 

8109 SPINAL FUSION NEC 

8111 ANKLE FUSION 

8112 TRIPLE ARTHRODESIS 

8113 SUBTALAR FUSION 

8114 MIDTARSAL FUSION 

8115 TARSOMETATARSAL FUSION 

8116 METATARSOPHALANGEAL FUS 

8117 OTHER FUSION OF FOOT 

8118 OTHER FUSION OF TOE 

8120 ARTHRODESIS NOS 

8121 ARTHRODESIS OF HIP 

8122 ARTHRODESIS OF KNEE 

8123 ARTHRODESIS OF SHOULDER 

8124 ARTHRODESIS OF ELBOW 

8125 CARPORADIAL FUSION 

8126 METACARPOCARPAL FUSION 

8127 METACARPOPHALANGEAL FUS 

8128 INTERPHALANGEAL FUSION 

8129 ARTHRODESIS NEC 

8131 FOOT ARTHROPLAS W PROSTH 

8139 FOOT/TOE ARTHROPLAST NEC 

8141 TOTAL KNEE REPLACEMENT 

8142 FIVE-IN-ONE KNEE REPAIR 

8143 TRIAD KNEE REPAIR 

8144 PATELLAR STABILIZATION 

8145 CRUCIATE LIG REPAIR NEC 

8146 COLLATERL LIG REPAIR NEC 

8147 OTHER REPAIR OF KNEE 

8148 TOTAL ANKLE REPLACEMENT 

8149 OTHER REPAIR OF ANKLE 
8151 TOT HIP REPLACE -METHACRY 
8159 OTHER TOTAL HIP REPLACE 

8161 REPLAC FEM HEAD-METHACRY 

8162 REPLACE FEMORAL HEAD NEC 

8163 REPLACE ACETAB-METHACRYL 

8164 REPLACE ACETABULUM NEC 
8169 HIP REPAIR NEC 

8171 HAND ARTHROPLAS W PROSTH 

8179 HAND ARTHROPLASTY NEC 

8181 SHOULDER ARTHROPL- PROSTH 

8182 REP RECUR SHLDER DISLOC 

8183 SHOULDER ARTHROPLAST NEC 

8184 ELBOW ARTHROPLAST -PROSTH 

8185 ELBOW ARTHROPLASTY NEC 

8186 CARPAL ARTHROPL- SYN PROS 

8187 WRIST ARTHROPLASTY NEC 

8193 SUTUR CAPSUL/LIGAMEN ARM 

8194 SUTURE CAPSUL/LIG ANK/FT 

8195 SUTUR CAPSUL/LIG LEG NEC 

8196 OTHER REPAIR OF JOINT 
8198 OTHER JOINT DX PROCEDURE 



8199 JOINT STRUCTURE OP NEC 

8201 EXPLOR TEND SHEATH-HAND 

8202 MYOTOMY OF HAND 

8203 BURSOTOMY OF HAND 

8209 INC SOFT TISSUE HAND NEC 

8211 TENOTOMY OF HAND 

8212 FASCIOTOMY OF HAND 

8219 DIV SOFT TISSUE HAND NEC 

8221 EXC LES TEND SHEATH HAND 

8222 EXCISION HAND MUSCLE LES 
8229 EXC LES SFT TISS HND NEC 

8231 BURSECTOMY OF HAND 

8232 EXCIS HAND TEND FOR GRFT 

8233 HAND TENONECTOMY NEC 

8234 EXC HND MUS/FAS FOR GRFT 

8235 HAND FASCIECTOMY NEC 

8236 OTHER MYECTOMY OF HAND 
8239 HAND SOFT TISSUE EXC NEC 

8241 SUTURE TENDN SHEATH HAND 

8242 DELAY SUT FLEX TEND HAND 

8243 DELAY SUT HAND TEND NEC 

8244 SUTUR FLEX TEND HAND NEC 

8245 SUTURE HAND TENDON NEC 

8246 SUTURE HAND MUSCLE/FASC 

8251 HAND TENDON ADVANCEMENT 

8252 HAND TENDON RECESSION 

8253 HAND TENDON REATTACHMENT 

8254 HAND MUSCLE REATTACHMENT 
.8255 CHNG HND MUS/TEN LNG NEC 
8256 TRANSPLANT HAND TEND NEC 
825 7 TRANSPOSIT HAND TEND NEC 

8258 TRANSPLANT HAND MUSC NEC 

8259 TRANSPOSIT HAND MUSC NEC 
8261 POLLICIZATION OPERATION 
8269 THUMB RECONSTRUCTION NEC 

8271 HAND TEND PULLEY RECONST 

8272 PLAST OP HND-MUS/FAS GRF 
8279 PLAST OP HAND W GRFT NEC 

8281 TRANSFER OF FINGER 

8282 REPAIR OF CLEFT HAND 

8283 REPAIR OF MACRODACTYLY 

8284 REPAIR OF MALLET FINGER 

8285 OTHER TENODESIS OF HAND 

8286 OTHER TENOPLASTY OF HAND 
8289 HAND PLASTIC OP NEC 
8291 LYSIS OF HAND ADHESIONS 
8299 HAND MUS/TEN/FAS/OPS NEC 

8301 TENDON SHEATH EXPLORAT 

8302 MYOTOMY 

8303 BURSOTOMY 

8309 SOFT TISSUE INCISION NEC 

8311 ACHILLOTENOTOMY 

8312 ADDUCTOR TENOTOMY OF HIP 

8313 OTHER TENOTOMY 



Table 2.7— Continued 
ICD-9-CM operating room procedure codes 



8314 FASCIOTOMY 

8319 SOFT TISSUE DIVISION NEC 

8321 SOFT TISSUE BIOPSY 

8329 SOFT TISSUE DX PROC NEC 

8331 EXCIS LES TENDON SHEATH 

8332 EXCIS LESION OF MUSCLE 
8339 EXC LES SOFT TISSUE NEC 

8341 TENDON EXCISION FOR GRFT 

8342 OTHER TENONECTOMY 

8343 MUSC/FASC EXCIS FOR GRFT 

8344 OTHER FASCIECTOMY 

8345 OTHER MYECTOMY 

8349 OTHER SOFT TISSUE EXCIS 

835 BURSECTOMY 

8361 TENDON SHEATH SUTURE 

8362 DELAYED TENDON SUTURE 

8363 ROTATOR CUFF REPAIR 

8364 OTHER SUTURE OF TENDON 

8365 OTHER MUSCLE/FASC SUTURE 

8371 TENDON ADVANCEMENT 

8372 TENDON RECESSION 

8373 TENDON REATTACHMENT 

8374 MUSCLE REATTACHMENT 

8375 TENDON TRNSFR/TRANS PLANT 

8376 OTHER TENDON TRANSPOSIT 

8377 MUSCLE TRNSFR/TRANSPLANT 
8379 OTHER MUSCLE TRANSPOSIT 

8381 TENDON GRAFT 

8382 MUSCLE OR FASCIA GRAFT 

8383 TENDON PULLEY RECONSTRUC 

8384 CLUBFOOT RELEASE NEC 

8385 MUSC/TEND LNG CHANGE NEC 

8386 QUADRICEPSPLASTY 

8387 OTHER PLASTIC OPS MUSCLE 

8388 OTHER PLASTIC OPS TENDON 

8389 OTHER PLASTIC OPS FASCIA 

8391 ADHESIOLYSIS MUS/TEN/FAS 

8392 INSERT SKEL MUSC STIMULA 

8393 REMOV SKEL MUSC STIMULAT 

8399 MUS/TEN/FAS/BUR OP NEC 

8400 UPPER LIMB AMPUTAT NOS 

8401 FINGER AMPUTATION 

8402 THUMB AMPUTATION 

8403 AMPUTATION THROUGH HAND 

8404 DISARTICULATION OF WRIST 

8405 AMPUTATION THRU FOREARM 

8406 DISARTICULATION OF ELBOW 

8407 AMPUTATION THRU HUMERUS 

8408 SHOULDER DISARTICULATION 

8409 FOREQUARTER AMPUTATION 

8410 LOWER LIMB AMPUTAT NOS 

8411 TOE AMPUTATION 

8412 AMPUTATION THROUGH FOOT 

8413 DISARTICULATION OF ANKLE 



8414 AMPUTAT THROUGH MALLEOLI 

8415 BELOW KNEE AMPUTAT NEC 

8416 DISARTICULATION OF KNEE 

8417 ABOVE KNEE AMPUTATION 

8418 DISARTICULATION OF HIP 

8419 HINDQUARTER AMPUTATION 

8421 THUMB REATTACHMENT 

8422 FINGER REATTACHMENT 

8423 FOREARM/WRIST/HAND REATT 

8424 UPPER ARM REATTACHMENT 

8425 TOE REATTACHMENT 

8426 FOOT REATTACHMENT 

8427 LOWER LEG/ ANKLE REATTACH 

8428 THIGH REATTACHMENT 

8429 REATTACHMENT NEC 

843 AMPUTATION STUMP REVIS 

8440 IMPLNT/FIT PROS LIMB NOS 

8444 IMPLANT ARM PROSTHESIS 

8448 IMPLANT LEG PROSTHESIS 

8491 AMPUTATION NOS 

8492 SEPARAT EQUAL JOIN TWIN 

8493 SEPARAT UNEQUL JOIN TWIN 
8499 MUSCULOSKELETAL OP NEC 
8512 BREAST BIOPSY NEC 

8520 BREAST TISSU DESTRUC NOS 

8521 LOCAL EXCIS BREAST LES 

8522 QUADRANT RESECT BREAST 

8523 SUBTOTAL MASTECTOMY 

8524 EXC ECTOPIC BREAST TISSU 

8525 EXCISION OF NIPPLE 

8531 UNILAT REDUCT MAMMOPLAST 

8532 BILAT REDUCT MAMMOPLASTY 

8533 UNIL SUBQ MAMMECT-IMPLNT 

8534 UNILAT SUBQ MAMMECT NEC 

8535 BIL SUBQ MAMMECT -IMPLANT 

8536 BILAT SUBQ MAMMECTOM NEC 

8541 UNILAT SIMPLE MASTECTOMY 

8542 BILAT SIMPLE MASTECTOMY 

8543 UNILAT EXTEN SIMP MASTEC 

8544 BILAT EXTEND SIMP MASTEC 

8545 UNILAT RADICAL MASTECTOM 

8546 BILAT RADICAL MASTECTOMY 

8547 UNIL EXT RAD MASTECTOMY 

8548 BIL EXTEN RAD MASTECTOMY 
8550 AUGMENT MAMMOPLASTY NOS 

8553 UNILAT BREAST IMPLANT 

8554 BILATERAL BREAST IMPLANT 

856 M.STOPEXY 

857 TOTAL BREAST RECONSTRUCT 

8582 BREAST SPLIT-THICK GRAFT 

8583 BREAST FULL-THICK GRAFT 

8584 BREAST PEDICLE GRAFT 

8585 BREAST MUSCLE FLAP GRAFT 

8586 TRANSPOSITION OF NIPPLE 



37 



Table 2.7— Continued 
ICD-9-CM operating room procedure codes 



8587 NIPPLE REPAIR NEC 

8589 MAMMOPLASTY NEC 

8593 BREAST IMPLANT REVISION 

8594 BREAST IMPLANT REMOVAL 
8599 BREAST OPERATION NEC 
8609 SKIN SUBQ INCISION NEC 

8621 EXCISION OF PILONID CYST 

8622 WOUND DEBRIDEMENT 

8623 NAIL REMOVAL 
8625 DERMABRASION 

863 OTHER LOCAL DESTRUC SKIN 

864 RADICAL EXCIS SKIN LES 

8660 FREE SKIN GRAFT NOS 

8661 FULL-THICK HAND SKIN GRF 

8662 HAND SKIN GRAFT NEC 

8663 FULL-THICK SKIN GRFT NEC 

8665 HETEROGRAFT TO SKIN 

8666 HOMOGRAFT TO SKIN 



8669 FREE SKIN GRAFT NEC 

8670 PEDICLE GRAFT/FLAP NOS 

8671 CUT PREP PEDICLE GRAFT 

8672 PEDICLE GRAFT ADVANCEMEN 

8673 ATTACH PEDICLE TO HAND 

8674 ATTACH PEDICLE GRAFT NEC 

8675 REVISION OF PEDICLE GRFT 

8681 REPAIR FACIAL WEAKNESS 

8682 FACIAL RHYTIDECTOMY 

8683 SIZE REDUCT PLASTIC OP 

8684 RELAXATION OF SCAR 

8685 SYNDACTYLY CORRECTION 

8686 ONYCHOPLASTY 

8689 SKIN REPAIR PLASTY NEC 

8691 SKIN EXCISION FOR GRAFT 

8753 INTRAOPER CHOLANGIOGRAM 

9227 RADIOACTIVE ELEM IMPLANT 

9504 ANESTHETIZED EYE EXAM 



would be likely to increase the LOS in 75 percent of 
cases patients by at least 1 day. Table 2.8 describes all 
substantial comorbidities and complications identified. 
An addendum to this table is listed in Appendix XI. 

Both the variables presence or absence of a 
substantial complication or comorbidity and age were 
found to have a consistent relationship across MDCs. 
The presence of either substantial complication or 
comorbidity, or 70 years of age or over in certain 
groups, substantially increased resource consumption. 
If a patient had neither a substantial complication or 
comorbidity nor was 70 years of age or over, then 
their resource consumption would be lower. Thus, a 
composite variable based on the presence of 
complication or comorbidity and age was created. 
This variable is referred to as "age70cc". 

Complications or comorbidities and 70 years of age 
or over had four possible combinations as shown 
below: 



70 years of age 

No Yes 



Substantial No 1 2 

complication 
and/or 

comorbidity Yes 2 2 



If there were neither a substantial complication nor 
comorbidity present and under 70 years of age, then 
the age70cc variable had a "no" value. The "no" 
condition is shown by the cell labeled "1". Otherwise 
the age70cc variable had a "yes" value. The "yes" 
condition is shown in the three cells labeled "2". 

Strategy 

A patient classification scheme can serve not only 
to measure case-mix complexity, but also as an 
important management tool for the hospital. In the 
acute-care setting the physicians and not management 



are responsible for allocating the majority of 
resources. Therefore, an essential feature of the 
patient classification scheme must be that it can 
provide a framework or base for meaningful dialogue 
between administrative and medical staff. 

Methods need to be developed that can be used to 
categorize patients so that homogeneity within patient 
groups and heterogeneity between patient groups is 
achieved, with regard to the nature of the disorders. 
One approach utilized by the Yale ICD-9-CM 
research staff, was to seek physician participation on 
an on-going basis. Representation from the various 
medical and surgical specialties was obtained and built 
into the research protocol. Physician judgment was 
used through the formation of the ICD-9-CM DRGs 
in order to achieve what has been termed "clinical 
coherence" in the diagnostic groupings. 

Clinical coherence is generally defined as patient 
groups that are expected to evolve a set of clinical 
responses resulting in a similar pattern of resource 
use. However, during the course of this project, the 
term took on a wider meaning, resulting in the 
creation of: 

• Major diagnostic categories (MDCs) that are 
organized according to the organ system rather 
then etiology. 

• Formation of surgical and medical categories. 

• New variables such as operating room procedure, 
substantial comorbidities and complications. 

• Surgical hierarchy for almost all MDCs. 

Formation of DRGs using clinical input 

The statistical methodology employed for 
clustering cases is a variation of the Automated 
Interaction Method of Sonquist and Morgan 
presented in Appendix XII. In the initial phase of the 
project the feasibility of modifying the alogorithm 
was tested to understand the value of the dependent 
variable, and how this variable is influenced by the 



38 



Table 2.8 



ICD-9-CM diagnosis codes which represent substantial complications or comorbidities when 

as secondary diagnoses 



01100 TB 

01101 TB 

01102 TB 

01103 TB 

01104 TB 

01105 TB 

01106 TB 
OHIO TB 

01111 TB 

01112 TB 

01113 TB 

01114 TB 

01115 TB 

01116 TB 

01120 TB 

01121 TB 

01122 TB 

01123 TB 

01124 TB 

01125 TB 

01126 TB 

01130 TB 

01131 TB 

01132 TB 

01133 TB 

01134 TB 

01135 TB 

01136 TB 

01140 TB 

01141 TB 

01142 TB 

01143 TB 

01144 TB 

01145 TB 

01146 TB 

01150 TB 

01151 TB 

01152 TB 

01153 TB 

01154 TB 

01155 TB 

01156 TB 

01160 TB 

01161 TB 

01162 TB 

01163 TB 

01164 TB 

01165 TB 

01166 TB 

01170 TB 

01171 TB 

01172 TB 

01173 TB 

01174 TB 



LUNG INFILTR-UNSPEC 01175 

LUNG INFILTR-N0 EXAM 01176 

LUNG INFILTR-EXM UNKN 01180 

LUNG INFILTR -MICRO DX 01181 

LUNG INFILTR-CULT DX 01182 

LUNG INFILTR -HISTO DX 01183 

LUNG INFILTR-OTH TEST 01184 

LUNG NODULAR -UN SPEC 01185 

LUNG NODULAR-NO EXAM 01186 

LUNG NODUL-EXAM UNKN 01190 

LUNG NODULAR-MICRO DX 01191 

LUNG NODULAR-CULT DX 01192 

LUNG NODULAR-HISTO DX 01193 

LUNG NODULAR-OTH TEST 01194 

LUNG W CAVITY-UNSPEC 01195 

LUNG W CAVITY-NO EXAM 01196 

LUNG CAVITY-EXAM UNKN 01200 

LUNG W CAVIT-MICRO DX 01201 

LUNG W CAVITY-CULT DX 01202 

LUNG W CAVIT-HISTO DX 01203 

LUNG W CAVIT-OTH TEST 01204 

OF BRONCHUS -UNSPEC 01205 

OF BRONCHUS-NO EXAM 01206 

OF BRONCHUS -EXAM UNKN 01210 

OF BRONCHUS-MICRO DX 01211 

OF BRONCHUS -CULT DX 01212 

OF BRONCHUS-HISTO DX 01213 

OF BRONCHUS -OTH TEST 01214 

LUNG FIBROSIS-UNSPEC 01215 

LUNG FIBROSIS-NO EXAM 01216 

LUNG FIBROS-EXAM UNKN 01300 

LUNG FIBROS-MICRO DX 01301 

LUNG FIBROSIS-CULT DX 01302 

LUNG FIBROS-HISTO DX 01303 

LUNG FIBROS-OTH TEST 01304 

BRONCHIECTASIS-UNSPEC 01305 

BRONCHIECT-NO EXAM 01306 

BRONCHIECT-EXAM UNKN 01310 

BRONCHIECT-MICRO DX 01311 

BRONCHIECT-CULT DX 01312 

BRONCHIECT-HISTO DX 01313 

BRONCHIECT-OTH TEST 01314 

PNEUMONIA-UNSPEC 01315 

PNEUMONIA-NO EXAM 01316 

PNEUMONIA -EXAM UNKN 01320 

PNEUMONIA-MICRO DX 01321 

PNEUMONIA-CULT DX 01322 

PNEUMONIA-HISTO DX 01323 

PNEUMONIA-OTH TEST 01324 

PNEUMOTHORAX-UNSPEC 01325 

PNEUMOTHORAX -NO EXAM 01326 

PNEUMOTHORX-EXAM UNKN 01330 

PNEUMOTHORAX-MICRO DX 01331 

PNEUMOTHORAX -CULT DX 01332 



TB PNEUMOTHORAX -HISTO DX 
TB PNEUMOTHORAX -OTH TEST 
PULMONARY TB NEC -UNSPEC 
PULMONARY TB NEC -NO EXAM 
PULMON TB NEC -EXAM UNKN 
PULMON TB NEC -MICRO DX 
PULMON TB NEC -CULT DX 
PULMON TB NEC -HISTO DX 
PULMON TB NEC -OTH TEST 
PULMONARY TB NOS -UNSPEC 
PULMONARY TB NOS -NO EXAM 
PULMON TB NOS -EXAM UNKN 
PULMON TB NOS -MICRO DX 
PULMON TB NOS -CULT DX 
PULMON TB NOS -HISTO DX 
PULMON TB NOS -OTH TEST 
TB PLEURISY-UNSPEC 
TB PLEURISY -NO EXAM 
TB PLEURISY-EXAM UNKN 
TB PLEURISY-MICRO DX 
TB PLEURISY-CULT DX 
TB PLEURISY -HISTOLOG DX 
TB PLEURISY-OTH TEST 
TB THORACIC NODES-UNSPEC 
TB THORAX NODE -NO EXAM 
TB THORAX NODE -EXAM UNKN 
TB THORAX NODE -MICRO DX 
TB THORAX NODE -CULT DX 
TB THORAX NODE -HISTO DX 
TB THORAX NODE -OTH TEST 
TB MENINGITIS-UNSPEC 
TB MENINGITIS-NO EXAM 
TB MENINGITIS-EXAM UNKN 
TB MENINGITIS-MICRO DX 
TB MENINGITIS-CULT DX 
TB MENINGITIS-HISTO DX 
TB MENINGITIS-OTH TEST 
TUBRCLMA MENINGES -UNSPEC 
TUBRCLMA MENING-NO EXAM 
TUBRCLMA MENIN-EXAM UNKN 
TUBRCLMA MENING-MICRO DX 
TUBRCLMA MENING-CULT DX 
TUBRCLMA MENING-HISTO DX 
TUBRCLMA MENING-OTH TEST 
TUBERCULOMA BRAIN-UNSPEC 
TUBRCLOMA BRAIN-NO EXAM 
TUBRCLMA BRAIN-EXAM UNKN 
TUBRCLOMA BRAIN-MICRO DX 
TUBRCLOMA BRAIN-CULT DX 
TUBRCLOMA BRAIN-HISTO DX 
TUBRCLOMA BRAIN-OTH TEST 
TB BRAIN ABSCESS-UNSPEC 
TB BRAIN ABSCESS-NO EXAM 
TB BRAIN ABSC-EXAM UNKN 



419-177 0-84—4 



Table 2.8— Continued 

ICD-9-CM diagnosis codes which represent substantial complications or comorbidities when present as 

secondary diagnoses 



01333 TB BRAIN ABSC-MICRO DX 01601 TB 

01334 TB BRAIN ABSCESS-CULT DX 01602 TB 

01335 TB BRAIN ABSC-HISTO DX 01603 TB 

01336 TB BRAIN ABSC-0TH TEST 01604 TB 

01340 TUBRCLMA SP C0RD-UNSPEC 01605 TB 

01341 TUBRCLMA SP CORD-NO EXAM 01606 TB 

01342 TUBRCLMA SP CD-EXAM UNKN 01610 TB 

01343 TUBRCLMA SP CRD-MICRO DX 01611 TB 

01344 TUBRCLMA SP CORD-CULT DX 01612 TB 

01345 TUBRCLMA SP CRD-HISTO DX 01613 TB 

01346 TUBRCLMA SP CRD-OTH TEST 01614 TB 

01350 TB SP CRD ABSCESS-UNSPEC 01615 TB 

01351 TB SP CRD ABSC-NO EXAM 01616 TB 

01352 TB SP CRD ABSC-EXAM UNKN 01620 TB 

01353 TB SP CRD ABSC-MICRO DX 01621 TB 

01354 TB SP CRD ABSC-CULT DX 01622 TB 

01355 TB SP CRD ABSC-HISTO DX 01623 TB 

01356 TB SP CRD ABSC-OTH TEST 01624 TB 

01360 TB ENCEPHALITIS-UNSPEC 01625 TB 

01361 TB ENCEPHALITIS -NO EXAM 01626 TB 

01362 TB ENCEPHALIT-EXAM UNKN 01630 TB 

01363 TB ENCEPHALITIS -MICRO DX 01631 TB 

01364 TB ENCEPHALITIS-CULT DX 01632 TB 

01365 TB ENCEPHALITIS-HISTO DX 01633 TB 

01366 TB ENCEPHALITIS -OTH TEST 01634 TB 

01380 CNS TB NEC-UNSPEC 01635 TB 

01381 CNS TB NEC-NO EXAM 01636 TB 
01382. CNS TB NEC-EXAM UNKN 01640 TB 

01383 CNS TB NEC-MICRO DX 01641 TB 

01384 CNS TB NEC-CULT DX 01642 TB 

01385 CNS TB NEC-HISTO DX 01643 TB 

01386 CNS TB NEC-OTH TEST 01644 TB 

01390 CNS TB NOS-UNSPEC 01645 TB 

01391 CNS TB NOS-NO EXAM 01646 TB 

01392 CNS TB NOS-EXAM UNKN 01650 TB 

01393 CNS TB NOS-MICRO DX 01651 TB 

01394 CNS TB NOS-CULT DX 01652 TB 

01395 CNS TB NOS-HISTO DX 01653 TB 

01396 CNS TB NOS-OTH TEST 01654 TB 

01400 TB PERITONITIS-UNSPEC 01655 TB 

01401 TB PERITONITIS-NO EXAM 01656 TB 

01402 TB PERITONITIS-EXAM UNKN 01660 TB 

01403 T3 PERITONITIS-MICRO DX 01661 TB 

01404 TB PERITONITIS-CULT DX 01662 TB 

01405 TB PERITONITIS-HISTO DX 01663 TB 

01406 TB PERITONITIS-OTH TEST 01664 TB 

01480 INTESTINAL TB NEC-UNSPEC 01665 TB 

01481 INTESTIN TB NEC-NO EXAM 01666 TB 

01482 INTEST TB NEC-EXAM UNKN 01670 TB 

01483 INTESTIN TB NEC-MICRO DX 01671 TB 

01484 INTESTIN TB NEC-CULT DX 01672 TB 

01485 INTESTIN TB NEC-HISTO DX 01673 TB 

01486 INTESTIN TB NEC-OTH TEST 01674 TB 
01600 TB OF KIDNEY-UNSPEC 01675 TB 



OF KIDNEY -NO EXAM 
OF KIDNEY-EXAM UNKN 
OF KIDNEY-MICRO DX 
OF KIDNEY-CULT DX 
OF KIDNEY-HISTO DX 
OF KIDNEY-OTH TEST 
OF BLADDER-UNSPEC 
OF BLADDER-NO EXAM 
OF BLADDER-EXAM UNKN 
OF BLADDER-MICRO DX 
OF BLADDER-CULT DX 
OF BLADDER-HISTO DX 
OF BLADDER-OTH TEST 
OF URETER-UNSPEC 
OF URETER -NO EXAM 
OF URETER-EXAM UNKN 
OF URETER-MICRO DX 
OF URETER-CULT DX 
OF URETER-HISTO DX 
OF URETER -OTH TEST 
URINARY NEC-UNSPEC 
URINARY NEC -NO EXAM 
URINARY NEC -EXAM UNKN 
URINARY NEC -MICRO DX 
URINARY NEC -CULT DX 
URINARY NEC-HISTO DX 
URINARY NEC-OTH TEST 
EPIDIDYMIS-UNSPEC 
EPIDIDYMIS-NO EXAM 
EPIDIDYMIS -EXAM UNKN 
EPIDIDYMIS-MICRO DX 
EPIDIDYMIS-CULT DX 
EPIDIDYMIS-HISTO DX 
EPIDIDYMIS-OTH TEST 
MALE GENIT NEC-UNSPEC 
MALE GEN NEC -NO EXAM 
MALE GEN NEC -EX UNKN 
MALE GEN NEC -MICRO DX 
MALE GEN NEC -CULT DX 
MALE GEN NEC-HISTO DX 
MALE GEN NEC-OTH TEST 
OVARY TUBE-UNSPEC 
OVARY TUBE -NO EXAM 
OVARY/TUBE -EXAM UNKN 
OVARY TUBE-MICRO DX 
OVARY TUBE -CULT DX 
OVARY TUBE-HISTO DX 
OVARY TUBE -OTH TEST 
FEMALE GEN NEC-UNSPEC 
FEM GEN NEC -NO EXAM 
FEM GEN NEC -EXAM UNKN 
FEM GEN NEC -MICRO DX 
FEM GEN NEC -CULT DX 
FEM GEN NEC-HISTO DX 



40 



Table 2.8— Continued 

ICD-9-CM diagnosis codes which represent substantial complications or comorbidities when present as 

secondary diagnoses 



Ult>/b IB lrfc.fl lifcN NbU-Ulll Tt5i 

01690 GU TB NOS-UNSPEC 

01691 GU TB NOS -NO EXAM 

01692 GU TB NOS-EXAM UNKN 

01693 GU TB N0S-MICR0 DX 
0169 A GU TB NOS-CULT DX 

01695 GU TB NOS-HISTO DX 

01696 GU TB N0S-0TH TEST 

01720 TB PERIPH LYMPH-UNSPEC 

01721 TB PERIPH LYMPH-NO EXAM 

01722 TB PERIPH LYMPH-EXAM UNK 

01723 TB PERIPH LYMPH-MICRO DX 

01724 TB PERIPH LYMPH-CULT DX 

01725 TB PERIPH LYMPH-HISTO DX 

01726 TB PERIPH LYMPH-OTH TEST 

01730 TB OF EYE-UNSPEC 

01731 TB OF EYE-NO EXAM 

01732 TB OF EYE-EXAM UNKN 

01733 TB OF EYE-MICRO DX 

01734 TB OF EYE-CULT DX 

01735 TB OF EYE-HISTO DX 

01736 TB OF EYE-OTH TEST 

01740 TB OF EAR-UNSPEC 

01741 TB OF EAR-NO EXAM 

01742 TB OF EAR-EXAM UNKN 

01743 TB OF EAR-MICRO DX 

01744 TB OF EAR -CULT DX 

01745 TB OF EAR-HISTO DX 

01746 TB OF EAR-OTH TEST 

01750 TB OF THYROID-UNSPEC 

01751 TB OF THYROID-NO EXAM 

01752 TB OF THYROID -EXAM UNKN 

01753 TB OF THYROID-MICRO DX 

01754 TB OF THYROID-CULT DX 

01755 TB OF THYROID-HISTO DX 

01756 TB OF THYROID-OTH TEST 

01760 TB OF ADRENAL-UNSPEC 

01761 TB OF ADRENAL-NO EXAM 

01762 TB OF ADRENAL-EXAM UNKN 

01763 TB OF ADRENAL-MICRO DX 

01764 TB OF ADRENAL-CULT DX 

01765 TB OF ADRENAL-HISTO DX 

01766 TB OF ADRENAL-OTH TEST 

01770 TB OF SPLEEN-UNSPEC 

01771 TB OF SPLEEN-NO EXAM 

01772 TB OF SPLEEN-EXAM UNKN 

01773 TB OF SPLEEN-MICRO DX 

01774 TB OF SPLEEN-CULT DX 

01775 TB OF SPLEEN-HISTO DX 

01776 TB OF SPLEEN-OTH TEST 

01780 TB ESOPHAGUS -UNSPEC 

01781 TB ESOPHAGUS-NO EXAM 

01782 TB ESOPHAGUS -EXAM UNKN 

01783 TB ESOPHAGUS -MICRO I:X 



ui/04 id ciurnAijUd-uuiii ua 

01785 TB ESOPHAGUS -HISTO DX 

01786 TB ESOPHAGUS -OTH TEST 

01790 TB OF ORGAN NEC -UNSPEC 

01791 TB OF ORGAN NEC -NO EXAM 

01792 TB ORGAN NEC -EXAM UNKN 

01793 TB OF ORGAN NEC -MICRO DX 

01794 TB OF ORGAN NEC -CULT DX 

01795 TB OF ORGAN NEC -HISTO DX 

01796 TB OF ORGAN NEC -OTH TEST 

01800 ACUTE MILIARY TB -UNSPEC 

01801 ACUTE MILIARY TB-NO EXAM 

01802 AC MILIARY TB-EXAM UNKN 

01803 AC MILIARY TB -MICRO DX 

01804 ACUTE MILIARY TB-CULT DX 

01805 AC MILIARY TB-HISTO DX 

01806 AC MILIARY TB-OTH TEST 

01880 MILIARY TB NEC-UNSPEC 

01881 MILIARY TB NEC-NO EXAM 

01882 MILIARY TB NEC-EXAM UNKN 

01883 MILIARY TB NEC-MICRO DX 

01884 MILIARY TB NEC-CULT DX 

01885 MILIARY TB NEC-HISTO DX 

01886 MILIARY TB NEC-OTH TEST 

01890 MILIARY TB NOS-UNSPEC 

01891 MILIARY TB NOS-NO EXAM 

01892 MILIARY TB NOS-EXAM UNKN 

01893 MILIARY TB NOS-MICRO DX 

01894 MILIARY TB NOS-CULT DX 

01895 MILIARY TB NOS-HISTO DX 

01896 MILIARY TB NOS-OTH TEST 
0310 PULMONARY MYCOBACTERIA 

0360 MENINGOCOCCAL MENINGITIS 

0361 MENINGOCOCC ENCEPHALITIS 

0362 MENINGOCOCCEMIA 

0363 MENINGOCOCC ADRENAL SYND 

03640 MENINGOCOCC CARDITIS NOS 

03641 MENINGOCOCC PERICARDITIS 

03642 MENINGOCOCC ENDOCARDITIS 

03643 MENINGOCOCC MYOCARDITIS 

03681 MENINGOCOCC OPTIC NEURIT 

03682 MENINGOCOCC ARTHROPATHY 
03689 MENINGOCOCCAL INFECT NEC 
0369 MENINGOCOCCAL INFECT NOS 
037 TETANUS 

0380 STREPTOCOCCAL SEPTICEMIA 

0381 STAPHYLOCOCC SEPTICEMIA 

0382 PNEUMOCOCCAL SEPTICEMIA 

0383 ANAEROBIC SEPTICEMIA 

03840 GRAM-NEG SEPTICEMIA NOS 

03841 H. INFLUENAE SEPTICEMIA 

03842 E COLI SEPTICEMIA 

03843 PSEUDOMONAS SEPTICEMIA 

03844 SERRATIA SEPTICEMIA 



41 



Table 2.8— Continued 

ICD-9-CM diagnosis codes which represent substantial complications or comorbidities when present as 

secondary diagnoses 



03849 GRAM-NEG SEPTICEMIA NEC 

0388 SEPTICEMIA NEC 

0389 SEPTICEMIA NOS 
0400 GAS GANGRENE 

0462 SUBAC SCLEROS PANENCEPH 

0520 POSTVARICELLA ENCEPHALIT 

0521 VARICELLA PNEUMONITIS 

0527 VARICELLA COMPLICAT NEC 

0528 VARICELLA COMPLICAT NOS 

0529 VARICELLA UNCOMPLICATED 

0530 HERPES ZOSTER MENINGITIS 

05310 H ZOSTER NERV SYST NOS 

05311 GENICULATE HERPES ZOSTER 

05312 POSTHERPES TRIGEM NEURAL 

05313 POSTHERPES POLYNEUROPATH 
05319 H ZOSTER NERV SYST NEC 
05379 H ZOSTER COMPLICATED NEC 
0538 H ZOSTER COMPLICATED NOS 
0543 HERPETIC ENCEPHALITIS 
0545 HERPETIC SEPTICEMIA 

05471 VISCERAL HERPES SIMPLEX 

05472 H SIMPLEX MENINGITIS 
05479 H SIMPLEX COMPLICAT NEC 
0548 H SIMPLEX COMPLICAT NOS 

0550 POSTMEASLES ENCEPHALITIS 

0551 POSTMEASLES PNEUMONIA 

0552 POSTMEASLES OTITIS MEDIA 
05571 MEASLES KERATITIS 

05579 MEASLES COMPLICATION NEC 
0558 MEASLES COMPLICATION NOS 

05600 RUBELLA NERVE COMPL NOS 

05601 RUBELLA ENCEPHALITIS 
05609 RUBELLA NERVE COMPL NEC 
05671 ARTHRITIS DUE TO RUBELLA 
05679 RUBELLA COMPLICATION NEC 
0568 RUBELLA COMPLICATION NOS 

0702 HEPATITIS B WITH COMA 

0703 HEPATITIS B tf/O COMA 

0704 VIRAL HEPAT NEC W COMA 

0705 VIRAL HEPAT NEC W/O COMA 

0706 VIRAL HEPAT NOS W COMA 
0709 VIRAL HEPAT NOS W/O COMA 

0720 MUMPS ORCHITIS 

0721 MUMPS MENINGITIS 

0722 MUMPS ENCEPHALITIS 

0723 MUMPS PANCREATITIS 

07271 MUMPS HEPATITIS 

07272 MUMPS POLYNEUROPATHY 
07279 MUMPS COMPLICATION NEC 
0728 MUMPS COMPLICATION NOS 
0860 CHAGAS DISEASE OF HEART 

09040 JUVENILE NEUROSYPH NOS 

09041 CONGEN SYPH ENCEPHALITIS 

09042 CONGEN SYPH MENINGITIS 



09049 JUVENILE NEUROSYPH NEC 

0930 AORTIC ANEURYSM, SYPHIL 

0931 SYPHILITIC AORTITIS 
09320 SYPHIL ENDOCARDITIS NOS 
09 321 SYPHILITIC MITRAL VALVE 

09322 SYPHILITIC AORTIC VALVE 

09323 SYPHIL TRICUSPID VALVE 
09 324 SYPHIL PULMONARY VALVE 

09381 SYPHILITIC PERICARDITIS 

09382 SYPHILITIC MYOCARDITIS 
09389 CARDIOVASCULAR SYPH NEC 

0939 CARDIOVASCULAR SYPH NOS 

0940 TABES DORSALIS 

0941 GENERAL PARESIS 

0942 SYPHILITIC MENINGITIS 

0943 ASYMPTOMAT NEUROSYPHILIS 
09481 SYPHILITIC ENCEPHALITIS 
09487 SYPH RUPT CEREB ANEURYSM 
09489 NEUROSYPHILIS NEC 

0949 NEUROSYPHILIS NOS 
0980 ACUTE GC INFECT LOWER GU 
0980 ACUTE GC INFECT LOWER GU 
09810 GC (ACUTE) UPPER GU NOS 

09810 GC (ACUTE) UPPER GU NOS 

09811 GC CYSTITIS (ACUTE) 

09812 GC PROSTATITIS (ACUTE) 

09813 GC ORCHITIS (ACUTE) 

09814 GC SEM VESICULIT (ACUTE) 

09815 GC CERVICITIS (ACUTE) 

09816 GC ENDOMETRITIS (ACUTE) 

09817 ACUTE GC SALPINGITIS 
09819 GC (ACUTE) UPPER GU NEC 
09819 GC (ACUTE) UPPER GU NEC 

1124 CANDIDIASIS OF LUNG 

1125 DISSEMINATED CANDIDIASIS 

11281 CANDIDAL ENDOCARDITIS 

11282 CANDIDAL OTITIS EXTERNA 

11283 CANDIDAL MENINGITIS 
1140 PRIMARY COCCIDIOIDOMYCOS 

1142 COCCIDIOIDAL MENINGITIS 

1143 PROGRESS COCCIDIOID NEC 
1149 COCCIDIOIDOMYCOSIS NOS 

11500 HISTOPLASMA CAPSULAT NOS 

11501 HISTOPLASM CAPSUL MENING 

11502 HISTOPLASM CAPSUL RETINA 

11503 HISTOPLASM CAPS PERICARD 

11504 HISTOPLASM CAPS ENDOCARD 

11505 HISTOPLASM CAPS PNEUMON 

11510 HISTOPLASMA DUBOISII NOS 

11511 HISTOPLASM DUBOIS MENING 

11512 HISTOPLASM DUBOIS RETINA 

11513 HISTOPLASM DUB PERICARD 

11514 HISTOPLASM DUB ENDOCARD 

11515 HISTOPLASM DUB PNEUMONIA 



42 



Table 2.8— Continued 

ICD-9-CM diagnosis codes which represent substantial complications or comorbidities when present as 

secondary diagnoses 



11519 HISTOPLASMA DUBOISII NEC 

11590 HISTOPLASMOSIS NOS 

11591 HISTOPLASMOSIS MENINGIT 

11592 HISTOPLASMOSIS RETINITIS 

11593 HISTOPLASMOSIS PERICARD 

11594 HISTOPLASMOSIS ENDOCARD 

11595 HISTOPLASMOSIS PNEUMONIA 
11599 HISTOPLASMOSIS NEC 

1160 BLASTOMYCOSIS 

1161 PARACOCCIDIOIDOMYCOSIS 

1173 ASPERGILLOSIS 

1174 MYCOTIC MYCETOMAS 

1175 CRYPTOCOCCOSIS 

1176 ALLESCHERIOSIS 

1177 ZYGOMYCOSIS 

118 OPPORTUNISTIC MYCOSES 

1300 TOXOPLASM MENINGOENCEPH 

1301 TOXOPLASM CONJUNCTIVITIS 

1302 TOXOPLASM CHORIORETINIT 

1303 TOXOPLASMA MYOCARDITIS 

1304 TOXOPLASMA PNEUMONITIS 

1305 TOXOPLASMA HEPATITIS 

1307 TOXOPLASMOSIS SITE NEC 

1308 MULTISYSTEM TOXOPLASMOS 
135 SARCOIDOSIS 

1363 PNEUMOCYSTOSIS 

1370 LATE EFFECT TB , RESP/NOS 

1371 LATE EFFECT CNS TB 

1372 LATE EFFECT GU TB 

138 LATE EFFECT ACUTE POLIO 

1500 MAL NEO CERVICAL ESOPHAG 

1501 MAL NEO THORACIC ESOPHAG 

1502 MAL NEO ABDOMIN ESOPHAG 

1503 MAL NEO UPPER 3RD ESOPH 

1504 MAL NEO MIDDLE 3RD ESOPH 

1505 MAL NEO LOWER 3RD ESOPH 

1508 MAL NEO ESOPHAGUS NEC 

1509 MAL NEO ESOPHAGUS NOS 

1510 MAL NEO STOMACH CARDIA 

1511 MALIGNANT NEO PYLORUS 

1512 MAL NEO PYLORIC ANTRUM 

1513 MAL NEO STOMACH FUNDUS 

1514 MAL NEO STOMACH BODY 

1515 MAL NEO STOM LESSER CURV 

1516 MAL NEO STOM GREAT CURV 

1518 MALIG NEOPL STOMACH NEC 

1519 MALIG NEOPL STOMACH NOS 

1520 MALIGNANT NEOPL DUODENUM 

1521 MALIGN NT NEOPL JEJUNUM 

1522 MALIGNANT NEOPLASM ILEUM 

1523 MAL NEO MECKEL'S DIVERT 

1528 MAL NEO SMALL BOWEL NEC 

1529 MAL NEO SMALL BOWEL NOS 

1530 MAL NEO HEPATIC FLEXURE 



1531 MAL NEO TRANSVERSE COLON 

1532 MAL NEO DESCEND COLON 

1533 MAL NEO SIGMOID COLON 

1534 MALIGNANT NEOPLASM CECUM 

1535 MALIGNANT NEO APPENDIX 

1536 MALIG NEO ASCEND COLON 

1537 MAL NEO SPLENIC FLEXURE 

1538 MALIGNANT NEO COLON NEC 

1539 MALIGNANT NEO COLON NOS 

1540 MAL NEO RECTOSIGMOID JCT 

1541 MALIGNANT NEOPL RECTUM 

1542 MALIG NEOPL ANAL CANAL 

1543 MALIGNANT NEO ANUS NOS 
1548 MAL NEO RECTUM/ANUS NEC 

1550 MAL NEO LIVER, PRIMARY 

1551 MAL NEO INTRAHEPAT DUCTS 

1552 MALIGNANT NEO LIVER NOS 

1560 MALIG NEO GALLBLADDER 

1561 MAL NEO EXTRAHEPAT DUCTS 

1562 MAL NEO AMPULLA OF VATER 

1568 MALIG NEO BILIARY NEC 

1569 MALIG NEO BILIARY NOS 

1570 MAL NEO PANCREAS HEAD 

1571 MAL NEO PANCREAS BODY 

1572 MAL NEO PANCREAS TAIL 

1573 MAL NEO PANCREATIC DUCT 

1574 MAL NEO ISLET LANGERHANS 

1578 MALIG NEO PANCREAS NEC 

1579 MALIG NEO PANCREAS NOS 

1622 MALIG NEO MAIN BRONCHUS 

1623 MAL NEO UPPER LOBE LUNG 

1624 MAL NEO MIDDLE LOBE LUNG 

1625 MAL NEO LOWER LOBE LUNG 

1628 MAL NEO BRONCH/LUNG NEC 

1629 MAL NEO BRONCH/LUNG NOS 

1630 MAL NEO PARIETAL PLEURA 

1631 MAL NEO VISCERAL PLEURA 

1638 MALIG NEOPL PLEURA NEC 

1639 MALIG NEOPL PLEURA NOS 

1640 MALIGNANT NEOPL THYMUS 

1641 MALIGNANT NEOPL HEART 

1642 MAL NEO ANT MEDIASTINUM 

1643 MAL NEO POST MEDIASTINUM 

1648 MAL NEO MEDIASTINUM NEC 

1649 MAL NEO MEDIASTINUM NOS 

1890 MALIG NEOPL KIDNEY 

1891 MALIG NEO RENAL PELVIS 

1892 MALIGN NEOPL URETER 

1910 MALIGN NEOPL CEREBRUM 

1911 MALIG NEO FRONTAL LOBE 

1912 MAL NEO TEMPORAL LOBE 

1913 MAL NEO PARIETAL LOBE 

1914 MAL NEO OCCIPITAL LOBE 

1915 MAL NEO CEREB VENTRICLE 



43 



Table 2.8— Continued 

ICD-9-CM diagnosis codes which represent substantial complications or comorbidities when present as 

secondary diagnoses 



1916 MAL NEO CEREBELLUM NOS 20016 

1917 MAL NEO BRAIN STEM 20017 

1918 MALIG NEO BRAIN NEC 20018 

1919 MALIG NEO BRAIN NOS 20020 

1920 MAL NEO CRANIAL NERVES 20021 

1921 MAL NEO CEREBRAL MENING 20022 

1922 MAL NEO SPINAL CORD 20023 

1923 MAL NEO SPINAL MENINGES 20024 
1928 MAL NEO NERVOUS SYST NEC 20025 

1960 MAL NEO LYMPH-HEAD/NECK 20026 

1961 MAL NEO LYMPH- INTRATH0R 20027 

1962 MAL NEO LYMPH INTRA-ABD 20028 

1963 MAL NEO LYMPH-AXILLA/ARM 20080 

1965 MAL NEO LYMPH- INGUIN/LEG 20081 

1966 MAL NEO LYMPH- INTRAPELV 20082 

1968 MAL NEO LYMPH NODE -MULT 20083 

1969 MAL NEO LYMPH NODE NOS 20084 
19 70 SECONDARY MALIG NEO LUNG 20085 

1971 SEC MAL NEO MEDIASTINUM 20086 

1972 SECOND MALIG NEO PLEURA 20087 

1973 SEC MALIG NEO RESP NEC 20088 

1974 SEC MALIG NEO SM BOWEL 20100 

1975 SEC MALIG NEO LG BOWEL 20101 
19 76 SEC MAL NEO PERITONEUM 20102 

1977 SECOND MALIG NEO LIVER 20103 

1978 SEC MAL NEO GI NEC 20104 

1980 SECOND MALIG NEO KIDNEY 20105 

1981 SEC MALIG NEO URIN NEC 20106 

1982 SECONDARY MALIG NEO SKIN 20107 

1983 SEC MAL NEO BRAIN/SPINE 20108 

1984 SEC MALIG NEO NERVE NEC 20110 

1985 SECONDARY MALIG NEO BONE 20111 

1986 SECOND MALIG NEO OVARY 20112 

1987 SECOND MALIG NEO ADRENAL 20113 

19881 SECOND MALIG NEO BREAST 20114 

19882 SECOND MALIG NEO GENITAL 20115 
19882 SECOND MALIG NEO GENITAL 20116 
19889 SECONDARY MALIG NEO NEC 20117 
1990 MALIG NEO DISSEMINATED 20118 

20000 RETICULOSARCOMA UNSPEC 20120 

20001 RETICULOSARCOMA HEAD 20121 

20002 RETICULOSARCOMA THORAX 20122 

20003 RETICULOSARCOMA ABDOM 20123 

20004 RETICULOSARCOMA AXILLA 20124 

20005 RETICULOSARCOMA INGUIN 20125 

20006 RETICULOSARCOMA PELVIC 20126 

20007 RETICULOSARCOMA SPLEEN 20127 

20008 RETICULOSARCOMA MULT 20128 

20010 LYMPHOSARCOMA UNSPEC 20140 

20011 LYMPHOSARCOMA HEAD 20141 

20012 LYMPHOSARCOMA THORAX 20142 

20013 LYMPHOSARCOMA ABDOM 20143 

20014 LYMPHOSARCOMA AXILLA 20144 

20015 LYMPHOSARCOMA INGUIN 20145 



LYMPHOSARCOMA PELVIC 
LYMPHOSARCOMA SPLEEN 
LYMPHOSARCOMA MULT 
BURKITT'S TUMOR UNSPEC 
BURKITT 1 S TUMOR HEAD 
BURKITT'S TUMOR THORAX 
BURKITT'S TUMOR ABDOM 
BURKITT'S TUMOR AXILLA 
BURKITT'S TUMOR INGUIN 
BURKITT'S TUMOR PELVIC 
BURKITT'S TUMOR SPLEEN 
BURKITT'S TUMOR MULT 
MIXED LYMPHOSARC UNSPEC 
MIXED LYMPHOSARC HEAD 
MIXED LYMPHOSARC THORAX 
MIXED LYMPHOSARC ABDOM 
MIXED LYMPHOSARC AXILLA 
MIXED LYMPHOSARC INGUIN 
MIXED LYMPHOSARC PELVIC 
MIXED LYMPHOSARC SPLEEN 
MIXED LYMPHOSARC MULT 
HODGKINS PAkAGRAN UNSPEC 
HODGKINS PARAGRAN HEAD 
HODGKINS PARAGRAN THORAX 
HODGKINS PARAGRAN ABDOM 
HODGKINS PARAGRAN AXILLA 
HODGKINS PARAGRAN INGUIN 
HODGKINS PARAGRAN PELVIC 
HODGKINS PARAGRAN SPLEEN 
HODGKINS PARAGRAN MULT 
HODGKINS GRANULOM UNSPEC 
HODGKINS GRANULOM HEAD 
HODGKINS GRANULOM THORAX 
HODGKINS GRANULOM ABDOM 
HODGKINS GRANULOM AXILLA 
HODGKINS GRANULOM INGUIN 
HODGKINS GRANULOM PELVIC 
HODGKINS GRANULOM SPLEEN 
HODGKINS GRANULOM MULT 
HODGKINS SARCOMA UNSPEC 
HODGKINS SARCOMA HEAD 
HODGKINS SARCOMA THORAX 
HODGKINS SARCOMA ABDOM 
HODGKINS SARCOMA AXILLA 
HODGKINS SARCOMA INGUIN 
HODGKINS SARCOMA PELVIC 
HODGKINS SARCOMA SPLEEN 
HODGKINS SARCOMA MULT 
HODG LYMPH-HISTIO UNSPEC 
HODG LYMPH-HISTIO HEAD 
HODG LYMPH-HISTIO THORAX 
HODG LYMPH-HISTIO ABDOM 
HODG LYMPH-HISTIO AXILLA 
HODG LYMPH-HISTIO INGUIN 



44 



Table 2.8— Continued 

ICD-9-CM diagnosis codes which represent substantial complications or comorbidities when present as 

secondary diagnoses 



20146 HODG LYMPH-HISTIO PELVIC 

20147 HODG LYMPH-HISTIO SPLEEN 

20148 HODG LYMPH-HISTIO MULT 

20150 HODG NODUL SCLERO UNSPEC 

20151 HODG NODUL SCLERO HEAD 

20152 HODG NODUL SCLERO THORAX 

20153 HODG NODUL SCLERO ABDOM 

20154 HODG NODUL SCLERO AXILLA 

20155 HODG NODUL SCLERO INGUIN 

20156 HODG NODUL SCLERO PELVIC 

20157 HODG NODUL SCLERO SPLEEN 

20158 HODG NODUL SCLERO MULT 

20160 HODGKINS MIX CELL UNSPEC 

20161 HODGKINS MIX CELL HEAD 

20162 HODGKINS MIX CELL THORAX 

20163 HODGKINS MIX CELL ABDOM 

20164 HODGKINS MIX CELL AXILLA 

20165 HODGKINS MIX CELL INGUIN 

20166 HODGKINS MIX CELL PELVIC 

20167 HODGKINS MIX CELL SPLEEN 

20168 HODGKINS MIX CELL MULT 

20170 HODG LYMPH DEPLET UNSPEC 

20171 HODG LYMPH DEPLET HEAD 

20172 HODG LYMPH DEPLET THORAX 

20173 HODG LYMPH DEPLET ABDOM 

20174 HODG LYMPH DEPLET AXILLA 

20175 HODG LYMPH DEPLET INGUIN 

20176 HODG LYMPH DEPLET PELVIC 

20177 HODG LYMPH DEPLET SPLEEN 

20178 HODG LYMPH DEPLET MULT 

20190 HODGKINS DIS NOS UNSPEC 

20191 HODGKINS DIS NOS HEAD 

20192 HODGKINS DIS NOS THORAX 

20193 HODGKINS DIS NOS ABDOM 

20194 HODGKINS DIS NOS AXILLA 

20195 HODGKINS DIS NOS INGUIN 

20196 HODGKINS DIS NOS PELVIC 

20197 HODGKINS DIS NOS SPLEEN 

20198 HODGKINS DIS NOS MULT 

20200 NODULAR LYMPHOMA UNSPEC 

20201 NODULAR LYMPHOMA HEAD 

20202 NODULAR LYMPHOMA THORAX 

20203 NODULAR LYMPHOMA ABDOM 

20204 NODULAR LYMPHOMA AXILLA 

20205 NODULAR LYMPHOMA INGUIN 

20206 NODULAR LYMPHOMA PELVIC 

20207 NODULAR LYMPHOMA SPLEEN 

20208 NODULAR LYMPHOMA MULT 

20210 MYCOSIS FUNGOIDES UNSPEC 

20211 MYCOSIS FUNGOIDES HEAD 

20212 MYCOSIS FUNGOIDES THORAX 

20213 MYCOSIS FUNGOIDES ABDOM 

20214 MYCOSIS FUNGOIDES AXILLA 

20215 MYCOSIS FUNGOIDES INGUIN 



20216 MYCOSIS FUNGOIDES PELVIC 

20217 MYCOSIS FUNGOIDES SPLEEN 

20218 MYCOSIS FUNGOIDES MULT 

20220 SEZARY'S DISEASE UNSPEC 

20221 SEZARY'S DISEASE HEAD 

20222 SEZARY'S DISEASE THORAX 

20223 SEZARY'S DISEASE ABDOM 

20224 SEZARY'S DISEASE AXILLA 

20225 SEZARY'S DISEASE INGUIN 

20226 SEZARY'S DISEASE PELVIC 

20227 SEZARY'S DISEASE SPLEEN 

20228 SEZARY'S DISEASE MULT 

20230 MAL HISTIOCYTOSIS UNSPEC 

20231 MAL HISTIOCYTOSIS HEAD 

20232 MAL HISTIOCYTOSIS THORAX 

20233 MAL HISTIOCYTOSIS ABDOM 

20234 MAL HISTIOCYTOSIS AXILLA 

20235 MAL HISTIOCYTOSIS INGUIN 

20236 MAL HISTIOCYTOSIS PELVIC 

20237 MAL HISTIOCYTOSIS SPLEEN 

20238 MAL HISTIOCYTOSIS MULT 

20240 HAIRY-CELL LEUKEM UNSPEC 

20241 HAIRY-CELL LEUKEM HEAD 

20242 HAIRY-CELL LEUKEM THORAX 

20243 HAIRY-CELL LEUKEM ABDOM 

20244 HAIRY-CELL LEUKEM AXILLA 

20245 HAIRY-CELL LEUKEM INGUIN 

20246 HAIRY-CELL LEUKEM PELVIC 

20247 HAIRY-CELL LEUKEM SPLEEN 

20248 HAIRY-CELL LEUKEM MULT 

20250 LETTERER-SIWE DIS UNSPEC 

20251 LETTERER-SIWE DIS HEAD 

20252 LETTERER-SIWE DIS THORAX 

20253 LETTERER-SIWE DIS ABDOM 

20254 LETTERER-SIWE DIS AXILLA 

20255 LETTERER-SIWE DIS INGUIN 

20256 LETTERER-SIWE DIS PELVIC 

20257 LETTERER-SIWE DIS SPLEEN 

20258 LETTERER-SIWE DIS MULT 

20260 MAL MASTOCYTOSIS UNSPEC 

20261 MAL MASTOCYTOSIS HEAD 

20262 MAL MASTOCYTOSIS THORAX 

20263 MAL MASTOCYTOSIS ABDOM 

20264 MAL MASTOCYTOSIS AXILLA 

20265 MAL MASTOCYTOSIS INGUIN 

20266 MAL MASTOCYTOSIS PELVIC 

20267 MAL MASTOCYTOSIS SPLEEN 

20268 MAL MASTOCYTOSIS MULT 

20280 LYMPHOMA NEC UNSPEC SITE 

20281 LYMPHOMAS NEC HEAD 

20282 LYMPHOMAS NEC THORAX 

20283 LYMPHOMAS NEC ABDOM 

20284 LYMPHOMAS NEC AXILLA 

20285 LYMPHOMAS NEC INGUIN 



45 



Table 2.8— Continued 

ICD-9-CM diagnosis codes which represent substantial complications or comorbidities when present as 

secondary diagnoses 



20286 LYMPHOMAS NEC PELVIC 

20287 LYMPHOMAS NEC SPLEEN 

20288 LYMPHOMAS NEC MULT 

20290 LYMPHOID MAL NEC UNSPEC 

20291 LYMPHOID MAL NEC HEAD 

20292 LYMPHOID MAL NEC THORAX 

20293 LYMPHOID MAL NEC ABDOM 

20294 LYMPHOID MAL NEC AXILLA 

20295 LYMPHOID MAL NEC INGUIN 

20296 LYMPHOID MAL NEC PELVIC 

20297 LYMPHOID MAL NEC SPLEEN 

20298 LYMPHOID MAL NEC MULT 

2030 MULTIPLE MYELOMA 

2031 PLASMA CELL LEUKEMIA 
2038 IMMUNOPROLIFERAT NEO NEC 

2040 ACUTE LYMPHOID LEUKEMIA 

2041 CHR LYMPHOID LEUKEMIA 

2042 SUBAC LYMPHOID LEUKEMIA 

2048 LYMPHOID LEUKEMIA NEC 

2049 LYMPHOID LEUKEMIA NOS 

2050 ACUTE MYELOID LEUKEMIA 

2051 CHRONIC MYELOID LEUKEMIA 

2052 SUBACUT MYELOID LEUKEMIA 

2053 MYELOID SARCOMA 

2058 MYELOID LEUKEMIA NEC 

2059 MYELOID LEUKEMIA NOS 

2060 ACUTE MONOCYTIC LEUKEMIA 

2061 CHR MONOCYTIC LEUKEMIA 

2062 SUBAC MONOCYTIC LEUKEMIA 

2068 MONOCYTIC LEUKEMIA NEC 

2069 MONOCYTIC LEUKEMIA NOS 

2070 ACUTE ERYTHREMIA 

2071 CHRONIC ERYTHREMIA 

2072 MEGAKARYOCYTE LEUKEMIA 
2078 SPECIFIED LEUKEMIA NEC 

2080 ACUTE LEUKEMIA NOS 

2081 CHRONIC LEUKEMIA NOS 

2082 SUBACUTE LEUKEMIA NOS 

2088 LEUKEMIA -UNSPEC CELL NEC 

2089 LEUKEMIA-UNSPEC CELL NOS 

24200 TOX DIF GOITER NO CRISIS 

24201 TOX DIF GOITER W CRISIS 

24210 TOX UNINOD GOIT NO CRIS 

24211 TOX UNINOD GOIT W CRISIS 

24220 TOX MULTNOD GOIT NO CRIS 

24221 TOX MULTNOD GOIT W CRIS 

24230 TOX NOD GOITER NO CRISIS 

24231 TOX NOD GOITER W CRISIS 

24240 THYROTOX-ECT NOD NO CRIS 

24241 THYROTOX-ECT NOD W CRIS 

24280 THYRTOX ORIG NEC NO CRIS 

24281 THYROTOX ORIG NEC W CRIS 

24290 THYROTOX NOS NO CRISIS 

24291 THYROTOX NOS W CRISIS 



25001 DIABETES UNCOMPL JUVEN 

25010 DIAB KETOACIDOSIS ADULT 

25011 DIAB KETOACIDOSIS JUVEN 

25020 DIAB HYPEROSM COMA ADULT 

25021 DIAB HYPEROSM COMA JUVEN 

25030 DIABETES COMA NEC ADULT 

25031 DIABETES COMA NEC JUVEN 

25040 DIAB RENAL MAN IF ADULT 

25041 DIAB RENAL MANIF JUVEN 

25050 DIAB OPHTHAL MANIF ADULT 

25051 DIAB OPHTHAL MANIF JUVEN 

25060 DIAB NEURO MANIF ADULT 

25061 DIAB NEURO MANIF JUVEN 

25070 DIAB CIRCULAT DIS ADULT 

25071 DIAB CIRCULAT DIS JUVEN 

25080 DIAB W MANIF NEC ADULT 

25081 DIAB W MANIF NEC JUVEN 
2510 HYPOGLYCEMIC COMA 

2513 POSTSURG HYPOINSULINEMIA 
2521 HYPOPARATHYROIDISM 
2532 PANHYPOPITUITARISM 
2535 DIABETES INSIPIDUS 
2541 ABSCESS OF THYMUS 
2550 CUSHING'S SYNDROME 

2553 CORTICOADREN OVERACT NEC 

2554 CORTICOADRENAL INSUFFIC 

2555 ADRENAL HYPOFUNCTION NEC 

2556 MEDULLOADRENAL HYPERFUNC 

2580 WERMER'S SYNDROME 

2581 COMB ENDOCR DYSFUNCT NEC 

2588 POLYGLANDUL DYSFUNC NEC 

2589 POLYGLANDUL DYSFUNC NOS 
2592 CARCINOID SYNDROME 

260 KWASHIORKOR 

261 NUTRITIONAL MARASMUS 

262 OTH SEVERE MALNUTRITION 

2630 MALNUTRITION MOD DEGREE 

2631 MALNUTRITION MILD DEGREE 

2632 ARREST DEVEL D/T MALNUTR 

2638 PROTEIN-CAL MALNUTR NEC 

2639 PROTEIN-CAL MALNUTR NOS 
2690 DEFICIENCY OF VITAMIN K 
2733 MACROGLOBULINEMIA 

2760 HYPEROSMOLALITY 

2761 HYPOSMOLALITY 

2762 ACIDOSIS 

2763 ALKALOSIS 

2764 MIXED ACID-BASE BAL DIS 

2765 HYPOVOLEMIA 

2766 FLUID OVERLOAD 

2767 HYPERPOTASSEMIA 

2768 HYPOPOTASSEMIA 

2769 ELECTROLYT/FLUID DIS NEC 
27700 CYSTIC FIBROS W/O ILEUS 



46 



Table 2.8— Continued 

ICD-9-CM diagnosis codes which represent substantial complications or comorbidities when present as 

secondary diagnoses 



27701 CYSTIC FIRBOSIS W ILEUS 

27902 SELECTIVE IGM IMMUNODEF 

27903 SELECTIVE IG DEFIC NEC 

27904 CONG HYPOGAMMAGLOBULINEM 

27905 IMMUNODEFIC W HYPER-IGM 

27906 COMMON VARIABL IMMUNODEF 

27909 HUMORAL IMMUNITY DEF NEC 

27910 IMMUNDEF T-CELL DEF N0S 

27911 DIGEORGE'S SYNDROME 

27912 WISKOTT-ALDRICH SYNDROME 

27913 NEZELOF'S SYNDROME 
27919 DEFIC CELL IMMUNITY NOS 

2792 COMBINED IMMUNITY DEFIC 

2793 IMMUNITY DEFICIENCY NOS 

2794 AUTOIMMUNE DISEASE NEC 

2798 IMMUNE MECHANISM DIS NEC 

2799 IMMUNE MECHANISM DIS NOS 

2800 CHR BLOOD LOSS ANEMIA 
2814 PROTEIN DEFIC ANEMIA 
2818 NUTRITIONAL ANEMIA NEC 
2824 THALASSEMIAS 

28260 SICKLE-CELL ANEMIA NOS 

28261 HB-S DISEASE W/O CRISIS 

28262 HB-S DISEASE WITH CRISIS 

28263 SICKLE -CELL/HB-C DISEASE 
28269 SICKLE-CELL ANEMIA NEC 

2830 AUTOIMMUN HEMOLYTIC ANEM 

2831 NONAUTOIMMU HEMOLYT ANEM 

2832 HEMOLYTIC HEMOGLOBINURIA 

2839 ACQ HEMOLYTIC ANEMIA NOS 

2840 CONGEN APLASTIC ANEMIA 

2848 APLASTIC ANEMIAS NEC 

2849 APLASTIC ANEMIA NOS 

2850 SIDEROBLASTIC ANEMIA 

2851 AC POSTHEMORRHAG ANEMIA 

2860 CONG FACTOR VIII DIORD 

2861 CONG FACTOR IX DISORDER 

2862 CONG FACTOR XI DISORDER 

2863 CONG DEF CLOT FACTOR NEC 

2864 VON WILLEBRAND'S DISEASE 

2865 CIRCULATING ANTICOAG DIS 

2866 DEFIBRINATION SYNDROME 

2867 ACQ COAGUL FACTOR DEFIC 

2869 COAGULAT DEFECT NEC/NOS 

2870 ALLERGIC PURPURA 

2871 THROMBOCYTOPATHY 

2872 PURPURA NOS 

2873 PRIMARY THROMBOCYTOPENIA 

2874 SECOND THROMBOCYTOPENIA 

2875 THROMBOCYTOPENIA NOS 

2878 HEMORRHAGIC COND NEC 

2879 HEMORRHAGIC COND NOS 

2880 AGRANULOCYTOSIS 

2881 FUNCTION DIS NEUTROPHILS 



2910 DELIRIUM TREMENS 

2911 ALCOHOL AMNESTIC SYND 

2912 ALCOHOLIC DEMENTIA NEC 

2913 ALCOHOL HALLUCINOSIS 

2914 PATHOLOGIC ALCOHOL INTOX 

2918 ALCOHOLIC PSYCHOSIS NEC 

2919 ALCOHOLIC PSYCHOSIS NOS 

2920 DRUG WITHDRAWAL SYNDROME 

29211 DRUG PARANOID STATE 

29212 DRUG HALLUCINOSIS 
2922 PATHOLOGIC DRUG INTOX 

29281 DRUG-INDUCED DELIRIUM 

29282 DRUG- INDUCED DEMENTIA 

29283 DRUG AMNESTIC SYNDROME 

29284 DRUG DEPRESSIVE SYNDROME 
29289 DRUG MENTAL DISORDER NEC 
2929 DRUG MENTAL DISORDER NOS 

29500 SIMPL SCHIZOPHREN-UNSPEC 

29501 SIMPL SCHIZOPHREN-SUBCHR 

29502 SIMPLE SCHIZOPHREN-CHR 

29503 SIMP SCHIZ-SUBCHR/EXACER 

29504 SIMPL SCHIZO-CHR/EXACERB 

29510 HEBEPHRENIA-UNSPEC 

29511 HEBEPHRENIA-SUBCHRONIC 

29512 HEBEPHRENIA -CHRONIC 

29513 HEBEPHREN-SUBCHR/EXACERB 

29514 HEBEPHRENIA -CHR/EXACERB 

29521 CATATONIA-SUBCHRONIC 

29522 CATATONIA -CHRONIC 

29523 CATATONIA -SUBCHR/EXACERB 

29524 CATATONIA -CHR/EXACERB 

29530 PARANOID SCHIZO-UNSPEC 

29531 PARANOID SCHIZO-SUBCHR 

29532 PARANOID SCHIZO-CHRONIC 

29533 PARAN SCHIZO-SUBCHR/EXAC 

29534 PARAN SCHIZO-CHR/EXACERB 

29540 AC SCHIZOPHRENIA-UNSPEC 

29541 AC SCHIZOPHRENIA-SUBCHR 

29542 AC SCHIZOPHRENIA-CHR 

29543 AC SCHIZO-SUBCHR/EXACERB 

29544 AC SCHIZOPHR-CHR/EXACERB 

29560 RESID SCHIZOPHREN-UNSP 

29561 RESID SCHIZOPHREN-SUBCHR 

29562 RESIDUAL SCHIZOPHREN-CHR 

29563 RESID SCHIZO-SUBCHR/EXAC 

29564 RESID SCHIZO-CHR/EXACERB 

29570 SCHIZOAFFECTIVE-UNSPEC 

29571 SCHIZOAFFECTIVE-SUBCHR 

29572 SCHIZOAFFECTIVE-CHRONIC 

29573 SCHIZOAFF-SUBCHR/EXACER 

29574 SCHIZOAFFECT-CHR/EXACER 

29580 SCHIZOPHRENIA NEC- ..MSPEC 

29581 SCHIZOPHRENIA NEC-SUBCHR 

29582 SCHIZOPHRENIA NEC -CHR 



47 



Table 2.8— Continued 

ICD-9-CM diagnosis codes which represent substantial complications or comorbidities when present as 

secondary diagnoses 



29583 SCHIZO NEC - SUBCHR/EXACER 

29584 SCKIZO NEC-CHR/EXACERB 

29590 SCHIZOPHRENIA NOS-UNSPEC 

29591 SCHIZOPHRENIA NOS-SUBCHR 

29592 SCHIZOPHRENIA NOS-CHR 

29593 SCHIZO NOS- SUBCHR/EXACER 

29594 SCHIZO NOS-CHR/EXACERB 
29604 MANIC DIS-SEVERE W PSYCH 
29614 RECUR MANIC-SEV W PSYCHO 
29634 REC DEPR PSYCH-PSYCHOTIC 
29644 BIPOL MANIC-SEV W PSYCH 
29654 BIPOL DEPR-SEV W PSYCH 
29664 BIPOL MIXED-SEV W PSYCH 
2980 REACT DEPRESS PSYCHOSIS 

2983 ACUTE PARANOID REACTION 

2984 PSYCHOGEN PARANOID PSYCH 
29900 INFANTILE AUTISM-ACTIVE 
29910 DISINTEGR PSYCH-ACTIVE 
29980 CHILD PSYCHOS NEC-ACTIVE 
29990 CHILD PSYCHOS NOS-ACTIVE 

30300 AC ALCOHOL INTOX-UNSPEC 

30301 AC ALCOHOL INTOX-CONTIN 

30302 AC ALCOHOL INTOX-EPISOD 

30390 ALCOH DEP NEC/NOS-UNSPEC 

30391 ALCOH DEP. NEC/NOS-CONTIN 

30392 ALCOH DEP NEC/NOS-EPISOD 

30400 OPIOID DEPENDENCE -UNSPEC 

30401 OPIOID DEPENDENCE-CONTIN 

30402 OPIOID DEPENDENCE -EPISOD 

30410 BARBITURAT DEPEND-UNSPEC 

30411 BARBITURAT DEPEND-CONTIN 

30412 BARBITURAT DEPEND ■'EPISOD 

30440 AMPHETAMIN DEPEND-UNSPEC 

30441 AMPHETAMIN DEPEND-CONTIN 

30442 AMPHETAMIN DEPEND-EPISOD 

30470 OPIOID/OTHER DEP-UNSPEC 

30471 OPIOID/OTHER DEP-CONTIN 

30472 OPIOID/OTHER DEP-EPISOD 

30480 COMB DRUG DEP NEC-UNSPEC 

30481 COMB DRUG DEP NEC-CONTIN 

30482 COMB DRUG DEP NEC-EPISOD 

30490 DRUG DEPEND NOS-UNSPEC 

30491 DRUG DEPEND NOS-CONTIN 

30492 DRUG DEPEND NOS-EPISODIC 

30500 ALCOHOL ABUSE-UNSPEC 

30501 ALCOHOL ABUSE-CONTINUOUS 

30502 ALCOHOL ABUSE-EPISODIC 

30540 BARBITURATE ABUSE-UNSPEC 

30541 BARBITURATE ABUSE -CONTIN 

30542 BARBITURATE ABUSE-EPISOD 

30550 OPIOID ABUSE-UNSPEC 

30551 OPIOID ABUSE-CONTINUOUS 

30552 OPIOID ABUSE-EPISODIC 
30570 AMPHETAMINE ABUSE-UNSPEC 



30571 AMPHETAMINE ABUSE -CONTIN 

30572 AMPHETAMINE ABUSE-EPISOD 
3071 ANOREXIA NERVOSA 

3182 PROFOUND MENTAL RETARDAT 

3200 HEMOPHILUS MENINGITIS 

3201 PNEUMOCOCCAL MENINGITIS 

3202 STREPTOCOCCAL MENINGITIS 

3203 STAPHYLOCOCC MENINGITIS 

3207 MENING IN OTH BACT DIS 

3208 BACTERIAL MENINGITIS NEC 

3209 BACTERIAL MENINGITIS NOS 

3210 CRYPTOCOCCAL MENINGITIS 

3211 MENING IN OTH FUNGAL DIS 

3212 MENING IN OTH VIRAL DIS 

3213 TRYPANOSOMIASIS MENINGIT 

3214 MENINGIT D/T SARCOIDOSIS 
3218 MENING IN OTH NONBAC DIS 

3220 NONPYOGENIC MENINGITIS 

3221 EOSINOPHILIC MENINGITIS 

3222 CHRONIC MENINGITIS 
3229 MENINGITIS NOS 

3240 INTRACRANIAL ABSCESS 

3241 INTRASPINAL ABSCESS 
3249 CNS ABSCESS NOS 

325 PHLEBITIS INTRCRAN SINUS 
3314 OBSTRUCTIV HYDROCEPHALUS 
3350 WERDNIG -HOFFMANN DISEASE 

33510 SPINAL MUSCL ATROPHY NOS 

33511 KUGELBERG-WE LANDER DIS 

33519 SPINAL MUSCL ATROPHY NEC 

33520 AMYOTROPHIC SCLEROSIS 

33521 PROG MUSCULAR ATROPHY 

33522 PROGRESSIVE BULBAR PALSY 

33523 PSEUDOBULBAR PALSY 

33524 PRIM LATERAL SCLEROSIS 
33529 MOTOR NEURON DISEASE NEC 

3358 ANT HORN CELL DIS NEC 

3359 ANT HORN CELL DIS NOS 
340 MULTIPLE SCLEROSIS 
3432 CONGENITAL QUADRIPLEGIA 
3440 QUADRIPLEGIA NOS 

3451 GEN CONVULSIVE EPILEPSY 

3452 PETIT MAL STATUS 

3453 GRAND MAL STATUS 
3481 ANOXIC BRAIN DAMAGE 

3490 LUMBAR PUNCTURE REACTION 

3491 COMPLICATION CNS DEVICE 

34981 CEREBROSPINAL RHINORRHEA 

34982 TOXIC ENCEPHALOPATHY 

3580 MYASTHENIA GRAVIS 

3581 MYASTHENIA IN OTH DIS 

3590 CONG HERED MUSC DYSTRPHY 

3591 HERED PROG MUSC DYSTRPHY 
37700 PAPILLEDEMA NOS 



48 



Table 2.8— Continued 

ICD-9-CM diagnosis codes which represent substantial complications or comorbidities when present as 

secondary diagnoses 



37701 PAPILLEDEMA W INCR PRESS 

37702 PAPILLEDEMA W DECR PRESS 
38301 SUBPERI MASTOID ABSCESS 
38330 POSTMASTOID COMPL NOS 
38381 POSTAURICULAR FISTULA 

3940 MITRAL STENOSIS 

3941 RHEUMATIC MITRAL INSUFF 

3942 MITRAL STENOSIS W INSUFF 

3949 MITRAL VALVE DIS NEC/NOS 

3950 RHEUMAT AORTIC STENOSIS 

3951 RHEUMATIC AORTIC INSUFF 

3952 RHEUM AORTIC STEN/ INSUFF 

3959 RHEUM AORTIC DIS NEC/NOS 

3960 MITRAL/AORTIC STENOSIS 

3961 MITRAL STENOS/AORT INSUF 

3962 MITRAL INSUF/AORT STENOS 

3963 MITRAL/AORTIC VAL INSUFF 

3968 MITR/AORTIC MULT INV0LV 

3969 MITRAL/AORTIC V DIS NOS 

3970 TRICUSPID VALVE DISEASE 

3971 RHEUM PULMON VALVE DIS 

3979 RHEUM ENDOCARDITIS NOS 

3980 RHEUMATIC MYOCARDITIS 
39891 RHEUMATIC HEART FAILURE 
4010 MALIGNANT HYPERTENSION 

40200 MAL HYPERTEN HRT DIS NOS 

40201 MAL HYPERT HRT DIS W CHF 
40211 BENIGN HYP HRT DIS W CHF 
40291 HYPERTEN HEART DIS W CHF 
4030 MAL HYPERTENS RENAL DIS 
4040 MAL HYPERT HRT/RENAL DIS 
40501 MAL RENOVASC HYPERTENS 
40509 MAL SECOND HYPERTEN NEC 

4100 AMI ANTEROLATERAL WALL 

4101 AMI ANTERIOR WALL NEC 

4102 AMI INFEROLATERAL WALL 

4103 AMI INFEROPOSTERIOR WALL 

4104 AMI INFERIOR WALL NEC 

4105 AMI LATERAL WALL NEC 

4106 TRUE POSTERIOR INFARCT 

4107 SUBENDOCARDIAL INFARCT 

4108 MYOCARDIAL INFARCT NEC 

4109 MYOCARDIAL INFARCT NOS 

4110 POST MI SYNDROME 

4111 INTERMED CORONARY SYND 
4118 AC ISCHEMIC HRT DIS NEC 

4130 ANGINA DECUBITUS 

4131 PRINZMETAL ANGINA 

4139 ANGINA PECTORIS NEC/NOS 

4150 ACUTE COR PULMONALE 

4151 PULMON EMBOLISM/ INFARCT 
4160 PRIM PULM HYPERTENSION 
4200 AC PERICARDIT IN OTH DIS 
42090 ACUTE PERICARDITIS NOS 



42091 AC IDIOPATH PERICARDITIS 
42099 ACUTE PERICARDITIS NEC 

4210 AC/SUBAC BACT ENDOCARD 

4211 AC ENDOCARD IT IN OTH DIS 

4219 AC/SUBAC ENDOCARD IT NOS 

4220 AC MYOCARDIT IN OTH DIS 

42290 ACUTE MYOCARDITIS NOS 

42291 IDIOPATHIC MYOCARDITIS 

42292 SEPTIC MYOCARDITIS 

42293 TOXIC MYOCARDITIS 
42299 ACUTE MYOCARDITIS NEC 

4230 HEMOPERICARDIUM 

4231 ADHESIVE PERICARDITIS 

4232 CONSTRICTIV PERICARDITIS 

4240 MITRAL VALVE DISORDER 

4241 AORTIC VALVE DISORDER 

4242 NONRHEUM TRICUSP VAL DIS 

4243 PULMONARY VALVE DISORDER 

42490 ENDOCARDITIS NOS 

42491 ENDOCARDITIS IN OTH DIS 
42499 ENDOCARDITIS NEC 

4250 ENDOMYOCARDIAL FIBROSIS 

4251 HYPERTR OBSTR CARDIOMYOP 

4252 OBSC AFRIC CARDIOMYOPATH 

4253 ENDOCARD FIBROELASTOSIS 

4254 PRIM CARDIOMYOPATHY NEC 

4255 ALCOHOLIC CARDIOMYOPATHY 

4257 METABOLIC CARDIOMYOPATHY 

4258 CARDIOMYOPATH IN OTH DIS 

4259 SECOND CARDIOMYOPATH NOS 

4260 ATRIOVENT BLOCK COMPLETE 

42610 ATRIOVENT BLOCK NOS 

42611 ATRIOVENT BLOCK- 1ST DEGR 

42612 ATRIOVEN BLOCK-MOB ITZ II 

42613 AV BLOCK-2ND DEGREE NEC 

4262 LEFT BB HEMIBLOCK 

4263 LEFT BB BLOCK NEC 

4264 RT BUNDLE BRANCH BLOCK 

42650 BUNDLE BRANCH BLOCK NOS 

42651 RT BBB/LFT POST FASC BLK 

42652 RT BBB/LFT ANT FASC BLK 

42653 BILAT BB BLOCK NEC 

42654 TRIFASCICULAR BLOCK 

4266 OTHER HEART BLOCK 

4267 ANOMALOUS AV EXCITATION 
42681 LOWN - GANONG - LE V INE SYND 
42689 CONDUCTION DISORDER NEC 

4269 CONDUCTION DISORDER NOS 

4270 PAROX ATRIAL TACHYCARDIA 

4271 PAROX VENTRIC TACHYCARD 

4272 PAROX TACHYCARDIA NOS 

42731 ATRIAL FIBRILLATION 

42732 ATRIAL FLUTTER 

42741 VENTRICULAR FIBRILLATION 



49 



Table 2.8— Continued 

ICD-9-CM diagnosis codes which represent substantial complications or comorbidities when present as 

secondary diagnoses 



42742 VENTRICULAR FLUTTER 
4275 CARDIAC ARREST 

4280 CONGESTIVE HEART FAILURE 

4281 LEFT HEART FAILURE 

4289 HEART FAILURE NOS 

4290 MYOCARDITIS NOS 

4294 HRT DIS POSTCARDIAC SURG 

4295 CHORDAE TENDINAE RUPTURE 

4296 PAPILLARY MUSCLE RUPTURE 

42981 PAPILLARY MUSCLE DIS NEC 

42982 HYPERKINETIC HEART DIS 

430 SUBARACHNOID HEMORRHAGE 

431 INTRACEREBRAL HEMORRHAGE 

4320 NONTRAUM EXTRADURAL HEM 

4321 SUBDURAL HEMORRHAGE 

4330 BASILAR ARTERY OCCLUSION 

4331 CAROTID ARTERY OCCLUSION 

4332 VERTEBRAL ART OCCLUSION 

4333 MULT PRECEREB OCCLUSION 

4340 CEREBRAL THROMBOSIS 

4341 CEREBRAL EMBOLISM 

4349 CEREBR ARTERY OCCLUS NOS 
436 CVA 

4372 HYPERTENS ENCEPHALOPATHY 

4374 CEREBRAL ARTERITIS 

4375 MOYAMOYA DISEASE 

4376 NONPYOGEN THROMBOS SINUS 

4410 DISSECTING ANEURYSM 

4411 RUPTUR THORACIC ANEURYSM 
4413 RUPT ABD AORTIC ANEURYSM 
4415 RUPT AORTIC ANEURYSM NOS 

4440 ABD AORTIC EMBOLISM 

4441 THORACIC AORTIC EMBOLISM 

44421 UPPER EXTREMITY EMBOLISM 

44422 LOWER EXTREMITY EMBOLISM 
44481 ILIAC ARTERY EMBOLISM 
44489 ARTERIAL EMBOLISM NEC 
4449 ARTERIAL EMBOLISM NOS 
4460 POLYARTERITIS NODOSA 

4462 HYPERSENSITIV ANGIITIS 

4463 LETHAL MIDLINE GRANULOMA 

4464 WEGENER'S GRANULOMATOSIS 

4465 GIANT CELL ARTERITIS 

4466 THROMBOT MICROANGIOPATHY 

4467 TAKAYASU'S DISEASE 
4470 ACQ ARTERIOVEN FISTULA 
4480 HEREDIT HEMORR TELANGIEC 
4510 SUPERFIC PHLEBITIS-LEG 
45111 FEMORAL VEIN PHLEBITIS 
45119 DEEP PHLEBITIS-LEG NEC 
4512 THROMBOPHLEBITIS LEG NOS 
45181 ILIAC THROMBOPHLEBITIS 
452 PORTAL VEIN THROMBOSIS 
4530 BUDD-CHIARI SYNDROME 



4531 THROMBOPHLEBITIS MIGRANS 

4532 VENA CAVA THROMBOSIS 

4533 RENAL VEIN THROMBOSIS 
4560 ESOPHAG VARICES W BLEED 
45620 BLEED ESOPH VAR OTH DIS 
4572 LYMPHANGITIS 

4590 HEMORRHAGE NOS 
46411 AC TRACHEITIS W OBSTRUCT 
46421 AC LARYNGOTRACH W OBSTR 
46431 AC EPIGLOTTITIS W OBSTR 
475 PERITONSILLAR ABSCESS 

47821 CELLULITIS OF PHARYNX 

47822 PARAPHARYNGEAL ABSCESS 
47824 RETROPHARYNGEAL ABSCESS 

47830 VOCAL CORD PARALYSIS NOS 

47831 VOCAL PARAL UNILAT PART 

47832 VOCAL PARAL UNILAT TOTAL 

47833 VOCAL PARAL BILAT PART 

47834 VOCAL PARAL BILAT TOTAL 
481 PNEUMOCOCCAL PNEUMONIA 

4820 K. PNEUMONIAE PNEUMONIA 

4821 PSEUDOMONAL PNEUMONIA 

4822 H. INFLUENZAE PNEUMONIA 

4823 STREPTOCOCCAL PNEUMONIA 

4824 STAPHYLOCOCCAL PNEUMONIA 

4828 BACTERIAL PNEUMONIA NEC 

4829 BACTERIAL PNEUMONIA NOS 
483 PNEUMONIA: ORGANISM NEC 
4841 PNEUM W CYTOMEG INCL DIS 
4843 PNEUMONIA IN WHOOP COUGH 

4845 PNEUMONIA IN ANTHRAX 

4846 PNEUM IN ASPERGILLOSIS 

4847 PNEUM IN OTH SYS MYCOSES 

4848 PNEUM IN INFECT DIS NEC 

485 BRONCOPNEUMONIA ORG NOS 

486 PNEUMONIA, ORGANISM NOS 
4870 INFLUENZA WITH PNEUMONIA 

4911 MUCOPURUL CHR BRONCHITIS 

4912 OBSTRUCT CHR BRONCHITIS 

4918 CHRONIC BRONCHITIS NEC 

4919 CHRONIC BRONCHITIS NOS 
4928 EMPHYSEMA NEC 

49 301 EXT ASTHMA W STATUS ASTH 
49311 INT ASTHMA W STATUS ASTH 
49391 ASTHMA W STATUS ASTHMAT 
494 BRONCHIECTASIS 

4950 FARMERS' LUNG 

4951 BAGASSOSIS 

4952 BIRD-FANCIERS' LUNG 

4953 SUBEROSIS 

4954 MALT WORKERS' LUNG 

4955 MUSHROOM WORKERS' LUNG 

4956 MAPL BARK-STRIPPRS 1 LUNG 

4957 "VENTILATION" PNEUMONIT 



50 



Table 2.8— Continued 

8CD-9-CM diagnosis codes which represent substantial complications or comorbidities when present as 

secondary diagnoses 



4958 ALLERG ALVEOL/PNEUM NEC 

4959 ALLERG ALVEOL/PNEUM NOS 
496 CHR AIRWAY OBSTRUCT NEC 

500 COAL WORKERS* PNEUMOCON 

501 ASBESTOSIS 

502 SILICA PNEUMOCON NEC 

503 INORG DUST PNEUMOCON NEC 

504 DUST PNEUMONOPATHY NEC 

505 PNEUMOCONIOSIS NOS 

5060 FUM/VAPOR BRONC/PNEUMON 

5061 FUM/VAPOR AC PULM EDEMA 

5070 FOOD/VOMIT PNEUMONITIS 

5071 OIL/ESSENCE PNEUMONITIS 
5078 SOLID/LIQ PNEUMONIT NEC 

5080 AC PUL MANIF D/T RAD I AT 

5081 CHR PUL MANIF D/T RAD I AT 
5100 EMPYEMA WITH FISTULA 
5109 EMPYEMA W/0 FISTULA 
5111 BACT PLEUR/EFFUS NOT TB 

5118 PLEURAL EFFUS NEC NOT TB 

5119 PLEURAL EFFUSION NOS 

5120 SPONT TENS PNEUMOTHORAX 
5128 SPONT PNEUMOTHORAX NEC 

5130 ABSCESS OF LUNG 

5131 ABSCESS OF MEDIASTINUM 
515 POST INF LAM PULM FIBROSIS 

5160 PUL ALVEOLAR PROTEINOSIS 

5161 IDIO PULM HEMOSIDEROSIS 

5162 PULM ALVEOLAR MICROLITH 

5163 IDIO FIBROS ALVEOLITIS 

5168 ALVEOL PNEUMONOPATHY NEC 

5169 ALVEOL PNEUMONOPATHY NOS 

5171 RHEUMATIC PNEUMONIA 

5172 SYST SCLEROSIS LUNG DIS 
5178 LUNG INVOLV IN OTH DIS 

5180 PULMONARY COLLAPSE 

5181 INTERSTITIAL EMPHYSEMA 

5184 ACUTE LUNG EDEMA NOS 

5185 POST TRAUM PULM INSUFFIC 
5190 TRACHEOSTOMY COMPLIC 
5192 MEDIASTINITIS 

5273 SALIVARY GLAND ABSCESS 

5274 SALIVARY GLAND FISTULA 
5283 CELLULITIS/ABSCESS MOUTH 
5304 PERFORATION OF ESOPHAGUS 
5307 MALLORY-WEISS SYNDROME 

53100 AC STOMACH ULCER W HEM 

53101 AC STOMAC ULC W "EM-OBST 

53110 AC STOMACH ULCER W PERF 

53111 AC STOM ULC W PERF-OBST 

53120 AC STOMAC ULC W HEM/PERF 

53121 AC STOM ULC HEM/PERF-OBS 
53131 AC STOMACH ULC NOS-OBSTR 
53140 CHR STOMACH ULC W HEM 



53141 CHR STOM ULC W HEM-OBSTR 

53150 CHR STOMACH ULCER W PERF 

53151 CHR STOM ULC W PERF-OBST 

53160 CHR STOMACH ULC HEM/PERF 

53161 CHR STOM ULC HEM/PERF-OB 
53171 CHR STOMACH ULC NOS-OBST 
53191 STOMACH ULCER NOS-OBSTR 

53200 AC DUODENAL ULCER W HEM 

53201 AC DUODEN ULC W HEM-OBST 

53210 AC DUODENAL ULCER W PERF 

53211 AC DUODEN ULC PERF-OBSTR 

53220 AC DUODEN ULC W HEM/PERF 

53221 AC DUOD ULC HEM/PERF-OBS 
53231 AC DUODENAL ULC NOS-OBST 

53240 CHR DUODEN ULCER W HEM 

53241 CHR DUODEN ULC HEM-OBSTR 

53250 CHR DUODEN ULCER W PERF 

53251 CHR DUODEN ULC PERF-OBST 

53260 CHR DUODEN ULC HEM/PERF 

53261 CHR DUOD ULC HEM/PERF-OB 
53271 CHR DUODEN ULC NOS-OBSTR 
53291 DUODENAL ULCER NOS-OBSTR 

53300 AC PEPTIC ULCER W HEMORR 

53301 AC PEPTIC ULC W HEM-OBST 

53310 AC PEPTIC ULCER W PERFOR 

53311 AC PEPTIC ULC W PERF-OBS 

53320 AC PEPTIC ULC W HEM/PERF 

53321 AC PEPT ULC HEM/PERF-OBS 
53331 AC PEPTIC ULCER NOS-OBST 

53340 CHR PEPTIC ULCER W HEM 

53341 CHR PEPTIC ULC W HEM-OBS 

53350 CHR PEPTIC ULCER W PERF 

53351 CHR PEPTIC ULC PERF-OBST 

53360 CHR PEPT ULC W HEM/PERF 

53361 CHR PEPT ULC HEM/PERF-OB 
53371 CHR PEPTIC ULCER NOS-OBS 
53391 PEPTIC ULCER NOS-OBSTRUC 
5 3400 AC MARGINAL ULCER W HEM 
53401 AC MARGIN ULC W HEM-OBST 

53410 AC MARGINAL ULCER W PERF 

53411 AC MARGIN ULC W PERF-OBS 

53420 AC MARGIN ULC W HEM/PERF 

53421 AC MARG ULC HEM/PERF-OBS 
53431 AC MARGINAL ULC NOS-OBST 

53440 CHR MARGINAL ULCER W HEM 

53441 CHR MARGIN ULC W HEM-OBS 

53450 CHR MARGINAL ULC W PERF 

53451 CHR MARGIN ULC PERF-OBST 

53460 CHR MARGIN ULC HEM/PERF 

53461 CHR MARG ULC HEM/PERF-OB 
53471 CHR MARGINAL ULC NOS-OBS 
53491 GASTROJEJUN ULC NOS-OBST 
5350 ACUTE GASTRITIS 

5361 AC DILATION OF STOMACH 



51 



Table 2.8— Continued 

ICD-9-CM diagnosis codes which represent substantial complications or comorbidities when present as 

secondary diagnoses 



5370 ACQ PYLORIC STENOSIS 

5373 DUODENAL OBSTRUCTION NEC 

5374 GASTRIC/DUODENAL FISTULA 

5400 AC APPEND W PERITONITIS 

5401 ABSCESS OF APPENDIX 
5409 ACUTE APPENDICITIS NOS 

55000 UNILAT ING HERNIA W GANG 

55001 RECUR UNIL ING HERN-GANG 

55002 BILAT ING HERNIA W GANG 

55003 RECUR BIL ING HERN-GANG 

55010 UNILAT ING HERNIA W OBST 

55011 RECUR UNIL ING HERN-OBST 

55012 BILAT ING HERNIA W OBST 

55013 RECUR BIL ING HERN-OBSTR 

55100 UNIL FEMORAL HERN W GANG 

55101 REC UNIL FEM HERN W GANG 

55102 BILAT FEM HERN W GANG 

55103 RECUR BIL FEM HERN-GANG 
5511 UMBILICAL HERNIA W GANGR 

55120 GANGR VENTRAL HERNIA NOS 

55121 GANGR INCISIONAL HERNIA 
55129 GANG VENTRAL HERNIA NEC 
5513 DIAPHRAGM HERNIA W GANGR 

5518 HERNIA, SITE NEC W GANGR 

5519 HERNIA, SITE NOS W GANGR 

55200 UNIL FEMORAL HERN W OBST 

55201 REC UNIL FEM HERN W OBST 

55202 BIL FEMORAL HERN W 0BSTR 

55203 REC BIL FEM HERN W OBSTR 
5521 UMBILICAL HERNIA W OBSTR 

55220 OBSTR VENTRAL HERNIA NOS 

55221 OBSTR INCISIONAL HERNIA 
55229 OBSTR VENTRAL HERNIA NEC 
5523 DIAPHRAGM HERNIA W OBSTR 

5528 HERNIA, SITE NEC W OBSTR 

5529 HERNIA, SITE NOS tf OBSTR 
5570 AC VASC INSUFF INTESTINE 

5581 RADIATION GASTROENTERIT 

5582 TOXIC GASTROENTERITIS 

5600 INTUSSUSCEPTION 

5601 PARALYTIC ILEUS 

5602 VOLVULUS OF INTESTINE 

56030 IMPACTION INTESTINE NOS 

56031 GALLSTONE ILEUS 

56039 IMPACTION INTESTINE NEC 
56081 INTESTINAL ADHES W OBSTR 
56089 INTESTINAL OBSTRUCT NEC 
5609 INTESTINAL OBSTRUCT NOS 
566 ANAL RECTAL ABSCESS 

5670 PERITONITIS IN INFEC DIS 

5671 PNEUMOCOCCAL PERITONITIS 

5672 SUPPURAT PERITONITIS NEC 

5678 PERITONITIS NEC 

5679 PERITONITIS NOS 



56881 HEMOPERITONEUM 

5693 RECTAL ANAL HEMORRHAGE 

5695 INTESTINAL ABSCESS 

5696 ENTEROSTOMY MALFUNCTION 
56983 PERFORATION OF INTESTINE 
570 ACUTE NECROSIS OF LIVER 

5711 AC ALCOHOLIC HEPATITIS 

5712 ALCOHOL CIRRHOSIS LIVER 
57149 CHRONIC HEPATITIS NEC 

5715 CIRRHOSIS OF LIVER NOS 

5716 BILIARY CIRRHOSIS 

5720 ABSCESS OF LIVER 

5721 PORTAL PYEMIA 

5722 HEPATIC COMA 

5724 HEPATORENAL SYNDROME 

5731 HEPATITIS IN VIRAL DIS 

5732 HEPATITIS IN OTH INF DIS 

5733 HEPATITIS NOS 

5734 HEPATIC INFARCTION 

57400 CHOLELITH W AC CHOLECYST 

57401 CHOLELITH/ AC GB INF-OBST 

57410 CHOLELITH W CHOLECYS NEC 

57411 CHOLELITH/GB INF NEC-OBS 
57421 CHOLELITH IAS NOS W OBSTR 

57430 CHOLEDOCHOLITH/AC GB INF 

57431 CHOLEDOCHLITH/AC GB-OBST 

57440 CHOLEDOCHLITH/GB INF NEC 

57441 CHOLEDOCHLITH/GB NEC-OBS 

57450 CHOLEDOCHOLITHIASIS NOS 

57451 CHOLEDOCHLITH NOS W OBST 
5750 ACUTE CHOLECYSTITIS 

5752 OBSTRUCTION GALLBLADDER 

5753 HYDROPS OF GALLBLADDER 

5754 PERFORATION GALLBLADDER 

5755 FISTULA OF GALLBLADDER 

5756 GB CHOLESTEROLOSIS 
5758 DIS OF GALLBLADDER NEC 
5761 CHOLANGITIS 

5763 PERFORATION OF BILE DUCT 

5764 FISTULA OF BILE DUCT 
5770 ACUTE PANCREATITIS 

5772 PANCREAT CYST/PSEUDOCYST 

5780 HEMATEMESIS 

5781 MELENA 

5789 GASTROINTEST HEMORR NOS 
5793 INTEST POSTOP NONABSORB 
5800 AC PROLIFERAT NEPHRITIS 
5804 AC RAPIDLY PROGR NEPHRIT 
58081 AC NEPHRITIS IN OTH DIS 
58089 ACUTE NEPHRITIS NEC 

5809 ACUTE NEPHRITIS NOS 

5810 NEPHROTIC SYN, PROLIFER 

5811 EPIMEMBRANOUS NEPHRITIS 

5812 MEMBRANOPROLIF NEPHROSIS 



52 



Table 2.8— Continued 

ICD-9-CM diagnosis codes which represent substantial complications or comorbidities when present as 

secondary diagnoses 



5813 MINIMAL CHANGE NEPHROSIS 
58181 NEPHROTIC SYN IN OTH DIS 
58189 NEPHROTIC SYNDROME NEC 
5819 NEPHROTIC SYNDROME NOS 
5834 RAPIDLY PROG NEPHRIT NOS 

5845 LOWER NEPHRON NEPHROSIS 

5846 AC RENAL FAIL, CORT NECR 

5847 AC REN FAIL, MEDULL NECR 

5848 AC RENAL FAILURE NEC 

5849 ACUTE RENAL FAILURE NOS 
585 CHRONIC RENAL FAILURE 

59010 AC PYELONEPHRITIS NOS 

59011 AC PYELONEPHR W MED NECR 

5902 RENAL/PERIRENAL ABSCESS 

5903 PYELOURETERITIS CYSTICA 

59080 PYELONEPHRITIS NOS 

59081 PYELONEPHRIT IN OTH DIS 
5909 INFECTION OF KIDNEY NOS 
591 HYDRONEPHROSIS 

5921 CALCULUS OF URETER 
5935 HYDROURETER 

5950 ACUTE CYSTITIS 

5951 CHR INTERSTIT CYSTITIS 

5952 CHRONIC CYSTITIS NEC 
5954 CYSTITIS IN OTH DIS 

59581 CYSTITIS CYSTICA 

59582 IRRADIATION CYSTITIS 
59589 CYSTITIS NEC 

5959 CYSTITIS NOS 

5960 BLADDER NECK OBSTRUCTION 

5961 INTESTINOVESICAL FISTULA 

5962 VESICAL FISTULA NEC 
596* ATONY OF BLADDER 

5966 BLADDER RUPT, NONTRAUM 

5967 BLADDER WALL HEMORRHAGE 
5970 URETHRAL ABSCESS 

5981 TRAUM URETHRAL STRICTURE 

5982 POSTOP URETHRAL STRICTUR 
5990 URIN TRACT INFECTION NOS 
5994 URETHRAL FALSE PASSAGE 

5996 URINARY OBSTRUCTION NOS 

5997 HEMATURIA 

6010 ACUTE PROSTATITIS 

6012 ABSCESS OF PROSTATE 

6013 PROSTATOCYSTITIS 

6021 PROSTATIC CONGEST/HEMORR 
6031 INFECTED HYDROCELE 
6040 ORCHITIS WITH ABSCESS 

6071 BALANOPOSTHITIS 

6072 INFLAM DIS, PENIS NEC 

6073 PRIAPISM 

61172 LUMP OR MASS IN BREAST 
6140 AC SALPINGO-OOPHORITIS 
6143 ACUTE PARAMETRITIS 



6145 AC PELV PERITONITIS -FEM 
6150 AC UTERINE INFLAMMATION 

6163 BARTHOLIN'S GLND ABSCESS 

6164 ABSCESS OF VULVA NEC 

6190 URIN-GENITAL FISTUL, FEM 

6191 DIGEST-GENIT FISTUL, FEM 

6192 GENITAL-SKIN FISTUL, FEM 

6198 FEM GENITAL FISTULA NEC 

6199 FEM GENITAL FISTULA NOS 
6207 BROAD LIGAMENT HEMATOMA 

63400 SPON ABOR W PEL INF-UNSP 

63401 SPON ABOR W PELV INF- INC 

63402 SPON ABOR W PEL INF-COMP 

63410 SPON ABORT W HEMORR-UNSP 

63411 SPON ABORT W HEMORR-INC 

63412 SPON ABORT W HEMORR-COMP 

63420 SPON AB W PEL DAMAG-UNSP 

63421 SPON AB W PELV DAMAG-INC 

63422 SPON AB W PEL DAMAG-COMP 

63430 SPON AB W REN FAIL-UNSP 

63431 SPON AB W REN FAIL-INC 

63432 SPON AB W REN FAIL-COMP 

63440 SPON AB W METAB DIS-UNSP 

63441 SPON AB W METAB DIS-INC 

63442 SPON AB W METAB DIS-COMP 

63450 SPON ABORT W SHOCK-UNSP 

63451 SPON ABORT W SHOCK- INC 

63452 SPON ABORT W SHOCK-COMP 

63460 SPON ABORT W EMBOL-UNSP 

63461 SPON ABORT W EMBOL-INC 

63462 SPON ABORT W EMBOL-COMP 

63470 SPON AB W COMPL NEC-UNSP 

63471 SPON AB W COMPL NEC-INC 

63472 SPON AB W COMPL NEC-COMP 

63480 SPON AB W COMPL NOS-UNSP 

63481 SPON AB W COMPL NOS -INC 

63482 SPON AB W COMPL NOS-COMP 

63490 SPON ABORT UNCOMPL-UNSP 

63491 SPON ABORT UNCOMPL-INC 

63492 SPON ABORT UNCOMPL-COMP 

6390 POSTABORTION GU INFECT 

6391 POSTABORTION HEMORRHAGE 

6392 POSTABORT PELVIC DAMAGE 

6393 POSTABORT RENAL FAILURE 

6394 POSTABORT METABOLIC DIS 

6395 POSTABORTION SHOCK 

6396 POSTABORTION EMBOLISM 

6398 POSTABORTION COMPL NEC 

6399 POSTABORTION COMPL NOS 

64000 THREATENED ABORT-UNSPEC 

64001 THREATENED ABORT -DELIVER 
64003 THREATEN ABORT -ANTEPART 

64080 HEM EARLY PREG NEC-UNSP 

64081 HEM EARLY PREG NEC-DELIV 



53 



Table 2.8— Continued 

ICD-9-CM diagnosis codes which represent substantial complications or comorbidities when present as 

secondary diagnoses 



64083 HEM EARLY PG NEC-ANTEPAR 

64090 HEMORR EARLY PREG-UNSPEC 

64091 HEM EARLY P REG-DELIVERED 
64093 HEM EARLY PREG-ANTEPART 

64100 PLACENTA PREVIA-UNSPEC 

64101 PLACENTA PREVIA-DELIVER 
64103 PLACENTA PREVIA-ANTEPART 

64110 PLACENTA PREV HEM-UNSPEC 

64111 PLACENTA PREV HEM-DELIV 
64113 PLACEN PREV HEM-ANTEPART 

64130 C0AG DEF HEMORR-UNSPEC 

64131 C0AG DEF HEMORR-DELIVER 
64133 C0AG DEF HEMORR -ANTE PART 

64180 ANTEPART HEM NEC-UNSPEC 

64181 ANTEPARTUM HEM NEC -DELI V 
64183 ANTEPART HEM NEC-ANTEFAR 

64190 ANTEPART HEM N0S-UNSPEC 

64191 ANTEPARTUM HEM NOS-DELIV 
64193 ANTEPART HEM N0S-ANTEPAR 

64240 MILD/NOS PREECLAMP-UNSP 

64241 MILD/NOS PREECLAMP-DELIV 

64242 MILD PREECLAMP-DEL W P/P 

64243 MILD/NOS PREECLAMP-ANTEP 

64244 MILD/NOS PREECLAMP-P/P 

64250 SEVERE PREECLAMP-UNSPEC 

64251 SEVERE PREECLAMP -DELIVER 

64252 SEV PREECLAMP-DEL W P/P 

64253 SEV PREECLAMP -ANTEPARTUM 

64254 SEV PREECLAMP -POSTPARTUM 

64260 ECLAMPSIA-UNSPECIFIED 

64261 ECLAMPSIA-DELIVERED 

64262 ECLAMPSIA- DELI V W P/P 

64263 ECLAMPSIA-ANTEPARTUM 

64264 ECLAMPSIA-POSTPARTUM 

64270 TOX tf OLD HYPERTEN-UNSP 

64271 TOX tf OLD HYPERTEN-DELIV 

64272 TOX W OLD HYP-DEL W P/P 

64273 TOX tf OLD HYPER -ANTE PART 

64274 TOX W OLD HYPER-POSTPART 
64400 THREAT PREM LABOR-UNSPEC 
64403 THRT PREM LABOR-ANTEPART 
64410 THREAT LABOR NEC-UNSPEC 
64413 THREAT LABOR NEC-ANTEPAR 

64660 GU INFECT IN PREG-UNSPEC 

64661 GU INFECTION-DELIVERED 

64662 GU INFECT ION-DELI V tf P/P 

64663 GU INFECTION -ANTEPARTUM 

64664 GU INFECTION-POSTPARTUM 

64670 LIVER DIS IN PREG-UNSPEC 

64671 LIVER DISORDER-DELIVERED 
64673 LIVER DISORDER-ANTEPART 

64730 TB IN PREG-UNSPECIFIED 

64731 TUBERCULOSIS-DELIVERED 

64732 TUBERCULOSIS-DELIV W P/P 



64733 TUBERCULOSIS -ANTEPARTUM 

64734 TUBERCULOSIS -POSTPARTUM 

64740 MALARIA IN PREG-UNSPEC 

64741 MALARIA-DELIVERED 

64742 MALARIA-DELIVERED W P/P 

64743 MALARIA -ANTEPARTUM 

64744 MALARIA- POSTPARTUM 

64800 DIABETES IN PREG-UNSPEC 

64801 DIABETES -DELIVERED 

64802 DIABETES-DELIVERED W P/P 

64803 DIABETES -ANTEPARTUM 

64804 DIABETES -POSTPARTUM 

64830 DRUG DEPEND PREG-UNSPEC 

64831 DRUG DEPENDENCE -DELIVER 

64832 DRUG DEPENDEN-DEL W P/P 

64833 DRUG DEPENDENCE -ANTEPART 

64834 DRUG DEPENDENCE -POSTPART 

64850 CONGEN CV DIS PREG-UNSP 

64851 CONGEN CV DIS-DELIVERED 

64852 CONGEN CV DIS-DEL W P/P 

64853 CONGEN CV DIS -ANTEPARTUM 

64854 CONGEN CV DlS -POSTPARTUM 

64860 CV DIS NEC PREG-UNSPEC 

64861 CV DIS NEC PREG-DELIVER 

64862 CV DIS NEC-DELIVER W P/P 

64863 CV DIS NEC -ANTEPARTUM 

64864 CV DIS NEC -POSTPARTUM 

65930 SEPTICEMIA IN LABOR-UNSP 

65931 SEPTICEM IN LABOR-DELIV 
65933 SEPTICEM IN LABOR-ANTEPA 

66500 PRELABOR RUPT UTER-UNSP 

66501 PRELABOR RUPT UTERUS-DEL 
66503 PRELAB RUPT UTER-ANTEPAR 

66510 RUPTURE UTERUS NOS-UNSP 

66511 RUPTURE UTERUS NOS-DELIV 

66512 RUPT UTER NOS-DEL tf P/P 
66514 RUPT UTERUS NOS -POSTPART 
66632 P/P COAG DEF-DEL tf P/P 
66634 POSTPART COAG DEF-POSTPA 

66800 PULM COMPL IN DEL-UNSPEC 

66801 PULM COMPL IN DEL-DELIV 

66802 PULM COMPLIC-DEL tf P/P 

66803 PULM COMPLICAT -ANTEPART 

66804 PULM COMPLICAT-POSTPART 

66810 HEART COMPL IN DEL-UNSP 

66811 HEART COMPL IN DEL-DELIV 

66812 HEART COMPL-DEL tf P/P 

66813 HEART COMPLIC -ANTEPART 

66814 HEART COMPLIC-POSTPART 

66820 CNS COMPL LABOR/DEL-UNSP 

66821 CNS COMPL LAB/DEL-DELIV 

66822 CNS COMPLIC-DEL tf P/P 

66823 CNS COMPL IN DEL-ANTEPAR 

66824 CNS COMPL IN DEL-POSTPAR 



54 



Table 2.8— Continued 

ICD-9-CM diagnosis codes which represent substantial complications or comorbidities when present as 

secondary diagnoses 



66880 ANESTH COMP DEL NEC-UNSP 

66881 ANESTH COMPL NEC -DELIVER 

66882 ANESTH COMPL NEC -DEL P/P 

66883 ANESTH COMPL ANTEPARTUM 

66884 ANESTH COMPL-POSTPARTUM 

66890 ANESTH COMP DEL NOS-UNSP 

66891 ANESTH COMPL NOS -DELIVER 

66892 ANESTH COMPL NOS-DEL P/P 

66893 ANESTH COMPL -ANTEPARTUM 

66894 ANESTH COMPL-POSTPARTUM 

66910 OBSTETRIC SHOCK-UNSPEC 

66911 OBSTETRIC SHOCK-DELIVER 

66912 OBSTET SHOCK-DELIV W P/P 

66913 OBSTETRIC SHOCK-ANTEPAR 

66914 OBSTETRIC SHOCK-POSTPART 
66930 AC REN FAIL W DELIV-UNSP 
66932 AC REN FAIL-DELIV W P/P 
66934 AC RENAL FAILURE -POSTPAR 
67000 MAJOR PUERP INFECT-UNSP 
67002 MAJOR PUERP INF-DEL P/P 
67004 MAJOR PUERP INF-POSTPART 

67120 THROMBOPHLEB PREG-UNSPEC 

67121 THROMBOPHLEBITIS-DELIVER 

67122 THROMBOPHLEB -DELIV W P/P 

67123 THROMBOPHLEB IT -ANTEPART 

67124 THROMBOPHLEB IT-POSTPART 

67130 DEEP THROMB ANTEPAR-UNSP 

67131 DEEP THROM ANTEPAR-DELIV 
67133 DEEP VEIN THROMB -ANTEPAR 
67140 DEEP THROMB POSTPAR-UNSP 
67142 THROMB POSTPAR-DEL W P/P 
67144 DEEP VEIN THROMB -POSTPAR 

67300 OB AIR EMBOLISM-UNSPEC 

67301 OB AIR EMBOLISM-DELIVER 

67302 OB AIR EMBOL-DELIV W P/P 

67303 OB AIR EMBOLISM -ANTEPART 

67304 OB AIR EMBOLISM -POSTPART 

67310 AMNIOTIC EMBOLISM-UNSPEC 

67311 AMNIOTIC EMBOLISM-DELIV 

67312 AMNIOT EMBOL-DELIV W P/P 

67313 AMNIOTIC EMBOL-ANTEPART 

67314 AMNIOTIC EMBOL-POSTPART 

67320 OB PULM EMBOL NOS-UNSPEC 

67321 PULM EMBOL NOS -DELIVERED 

67322 PULM EMBOL NOS-DEL W P/P 

67323 PULM EMBOL NOS-ANTEPART 

67324 PULM EMBOL NOS-POSTPART 

67330 OB PYEMIC EMBOL-UNSPEC 

67331 OB PYEMIC EMBOL-DELIVER 

67332 OB PYEM EMBOL-DEL W P/P 

67333 OB PYEMIC EMBOL-ANTEPART 

67334 OB PYEMIC EMBOL-POSTPART 

67380 OB PULMON EMBOL NEC-UNSP 

67381 PULMON EMBOL NEC-DELIVER 



67382 PULM EMBOL NEC-DEL W P/P 

67383 PULMON EMBOL NEC-ANTEPAR 

67384 PULMON EMBOL NEC-POSTPAR 

67400 PUERP CEREBVASC DIS-UNSP 

67401 PUERP CEREBVAS DIS-DELIV 

67402 CEREBVAS DIS-DELIV W P/P 

67403 CEREBROVASC DIS -ANTEPART 

67404 CEREBROVASC DIS -POSTPART 
67410 DISRUPT C-SECT WND-UNSP 
67412 DISRUPT C-SECT-DEL W P/P 
67420 DISRUPT PERINEUM-UNSPEC 
67422 DISRUPT PERIN-DEL W P/P 
67424 DISRUPT PERINEUM-POSTPAR 

67510 BREAST ABSCESS PREG-UNSP 

67511 BREAST ABSCESS-DELIVERED 

67512 BREAST ABSCESS-DEL W P/P 

6800 CARBUNCLE OF FACE 

6801 CARBUNCLE OF NECK 

6802 CARBUNCLE OF TRUNK 

6803 CARBUNCLE OF ARM 

6804 CARBUNCLE OF HAND 

6805 CARBUNCLE OF BUTTOCK 

6806 CARBUNCLE OF LEG 

6807 CARBUNCLE OF FOOT 

6808 CARBUNCLE, SITE NEC 

6809 CARBUNCLE NOS 

6820 CELLULITIS OF FACE 

6821 CELLULITIS OF NECK 

6822 CELLULITIS OF TRUNK 

6823 CELLULITIS OF ARM 

6824 CELLULITIS OF HAND 

6825 CELLULITIS OF BUTTOCK 

6826 CELLULITIS OF LEG 

6827 CELLULITIS OF FOOT 

6828 CELLULITIS, SITE NEC 

6829 CELLULITIS NOS 

683 ACUTE LYMPHADENITIS 

684 IMPETIGO 

6850 PILONIDAL CYST W ABSCESS 

6944 PEMPHIGUS 

6945 PEMPHIGOID 
6950 TOXIC ERYTHEMA 

7070 DECUBITUS ULCER 

7071 CHRONIC ULCER OF LEG 
7080 ALLERGIC URTICARIA 

7100 SYST LUPUS ERYTHEMATOSIS 

7101 SYSTEMIC SCLEROSIS 

7103 DERMATOMYOSITIS 

7104 POLYMYOSITIS 

7108 DIFF CONNECT TIS DIS NEC 

71100 PYOGEN ARTHRITIS-UNSPEC 

71101 PYOGEN ARTHRITIS-SHLDER 

71102 PYOGEN ARTHRITIS-UP/ARM 

71103 PYOGEN ARTHRITIS-FOREARM 



55 



419-177 - 84 -- 5 



Table 2.8— Continued 

ICD-9-CM diagnosis codes which represent substantial complications or comorbidities when present as 

secondary diagnoses 



71104 PYOGEN ARTHRITIS -HAND 73095 

71105 PYOGEN ARTHRITIS-PELVIS 73096 

71106 PYOGEN ARTHRITIS -L/LEG 73097 

71107 PYOGEN ARTHRITIS -ANKLE 73098 

71108 PYOGEN ARTHRITIS NEC 73099 

71109 PYOGEN ARTHRITIS -MULT 7331 

71160 MYCOTIC ARTHRITIS -UNSPEC 74100 

71161 MYCOTIC ARTHRITIS -SHLDER 74101 

71162 MYCOTIC ARTHRITIS-UP/ARM 74102 

71163 MYCOTIC ARTHRIT -FOREARM 74103 

71164 MYCOTIC ARTHRITIS -HAND 74190 

71165 MYCOTIC ARTHRITIS-PELVIS 74191 

71166 MYCOTIC ARTHRITIS -L/LEG 74192 

71167 MYCOTIC ARTHRIT IS -ANKLE 74193 

71168 MYCOTIC ARTHRITIS NEC 7450 

71169 MYCOTIC ARTHRITIS -MULT 74510 

7141 FELTY'S SYNDROME 74511 

7142 SYST RHEUM ARTHRITIS NEC 74512 

71430 JUV RHEUM ARTHRITIS NOS 74519 

71431 POLYART JUV RHEUM ARTHR 7452 

71432 PAUCIART JUV RHEUM ARTHR 7453 

71433 MONOART JUV RHEUM ARTHR 7454 

72280 POSTLAMINECTOMY SYND NOS 74560 

72281 POSTLAMINECT SYND-CERV 74569 

72282 POSTLAMINECT SYND-THORAC 7457 

72283 POSTLAMINECT SYND-LUMBAR 74601 

7234 BRACHIAL NEURITIS NOS 74602 

7235 TORTICOLLIS NOS 7461 
7280 INFECTIVE MYOSITIS 7462 

73000 AC OSTEOMYELITIS-UNSPEC 7463 

73001 AC OSTEOMYELITIS -SHLDER 7464 

73002 AC OSTEOMYELITIS -UP/ ARM 7465 

73003 AC OSTEOMYELITIS-FOREARM 7466 

73004 AC OSTEOMYELITIS -HAND 7467 

73005 AC OSTEOMYELITIS-PELVIS 74681 

73006 AC OSTEOMYELITIS -L/LEG 74682 

73007 AC OSTEOMYELITIS -ANKLE 74683 

73008 AC OSTEOMYELITIS NEC 74684 

73009 AC OSTEOMYELITIS -MULT 74686 

73080 BONE INFECT NEC-UNSPEC 74710 

73081 BONE INFECT NEC-SHLDER 74711 

73082 BONE INFECT NEC-UP/ARM 74722 

73083 BONE INFECT NEC-FOREARM 7484 

73084 BONE INFECT NEC-HAND 7485 

73085 BONE INFECT NEC-PELVIS 74861 

73086 BONE INFECT NEC-L/LEG 7650 

73087 BONE INFECT NEC-ANKLE 7670 

73088 BONE INFECT NEC-OTH SITE 7685 

73089 BONE INFECT NEC-MULT 769 

73090 BONE INFEC NOS-UNSP SITE 7700 

73091 BONE INFECT NOS-SHLDER 7701 

73092 BONE INFECT NOS-UP/ARM 7702 

73093 BONE INFECT NOS-FOREARM 7703 

73094 BONE INFECT NOS-HAND 7704 



BONE INFECT NOS -PELVIS 
BONE INFECT NOS -L/LEG 
BONE INFECT NOS -ANKLE 
BONE INFECT NOS-OTH SITE 
BONE INFECT NOS -MULT 
PATHOLOGICAL FRACTURE 
SPIN BIF W HYDROCEPH NOS 
SPIN BIF W HYDRCEPH-CERV 
SPIN BIF W HYDRCEPH-DORS 
SPIN BIF W HYDRCEPH-LUMB 
SPINA BIFIDA 
SPINA BIFIDA-CERV 
SPINA BIFIDA-DORSAL 
SPINA BIF IDA -LUMBAR 
COMMON TRUNCUS 
COMPL TRANSPOS GREAT VES 
DOUBLE OUTLET RT VENTRIC 
CORRECT TRANSPOS GRT VES 
TRANSPOS GREAT VESS NEC 
TETRALOGY OF FALLOT 
COMMON VENTRICLE 
VENTRICULAR SEPT DEFECT 
ENDOCARD CUSHION DEF NOS 
ENDOCARD CUSHION DEF NEC 
COR BILOCULARE 
CONG PULMON VALV ATRESIA 
CONG PULMON VALVE STENOS 
CONG TRICUSP ATRES/STEN 
EBSTEIN'S ANOMALY 
CONG AORTA VALV STENOSIS 
CONG AORTA VALV INSUFFIC 
CONGEN MITRAL STENOSIS 
CONG MITRAL INSUFFICIENC 
HYPOPLAS LEFT HEART SYND 
CONG SUBAORTIC STENOSIS 
COR TRIATR LATUM 
INFUNDIB PULMON STENOSIS 
OBSTRUCT HEART ANOM NEC 
CONGENITAL HEART BLOCK 
COARCTATION OF AORTA 
INTERRUPT OF AORTIC ARCH 
AORTIC ATRESIA/STENOSIS 
CONGENITAL CYSTIC LUNG 
AGENESIS OF LUNG 
CONGEN BRONCHIECTASIS 
EXTREME IMMATURITY 
CEREBRAL HEM AT BIRTH 
SEVERE BIRTH ASPHYXIA 
RESPIRATORY DISTRESS SYN 
CONGENITAL PNEUMONIA 
NB MASSIVE ASPIRAT SYN 
NB INTERSTIT EMPHYSEMA 
NB PULMONARY HEMORRHAGE 
PRIMARY ATELECTASIS 



56 



Table 2.8— Continued 

ICD-9-CM diagnosis codes which represent substantial complications or comorbidities when present as 

secondary diagnoses 



7705 NB ATELECTASIS NEC/NOS 

7707 PERINATAL CHR RESP DIS 

7710 CONGENITAL RUBELLA 

7711 CONG CYTOMEGALOVIRUS INF 
7713 TETANUS NEONATORUM 

7 718 PERINATAL INFECTION NEC 

7721 NB INTRAVENTRICULAR HEM 

7722 NB SUBARACHNOID HEMORR 

7724 NB GI HEMORRHAGE 

7725 NB ADRENAL HEMORRHAGE 

7730 NB HEMOLYT DIS :RH ISOIMM 

7731 NB HEMOLYT DIS-ABO ISOIM 

7732 NB HEMOLYT DIS-ISOIM NEC 

7733 HYDROPS FETALIS : ISOIMM 

7734 NB KERNICTERUS : ISOIMMUN 

7 740 PER I NAT JAUND-HERED ANEM 

7741 PER I NAT JAUND : HEMOLYSIS 

7742 NEON AT JAUND PRETERM DEL 

77430 DELAY CONJUGAT JAUND NOS 

77431 NEONAT JAUND IN OTH DIS 

7 7439 DELAY CONJUGAT JAUND NEC 

7744 FETAL/NEONATAL HEPATITIS 

7745 PERINATAL JAUNDICE NEC 

7 746 FETAL/NEONATAL JAUND NOS 

7 747 NB KERNICTERUS 

7751 NEONAT DIABETES MELLITUS 

7752 NEONAT MYASTHENIA GRAVIS 

7753 NEONATAL THYROTOXICOSIS 

7754 HYPOCALCEM/HYPOMAGNES NB 

7755 NEONATAL DEHYDRATION 

7756 NEONATAL HYPOGLYCEMIA 

7757 LATE METAB ACIDOSIS NB 
7760 NB HEMORRHAGIC DISEASE 

7 761 NEONATAL THROMBOCYTOPEN 

7762 DISSEM INTRAVASC COAG NB 

7763 OTH NEONATAL COAG DIS 

7771 MECONIUM OBSTRUCTION 

7772 INTEST OBST-INSPISS MILK 

7775 NECROT ENTEROCOLITIS NB 

7776 PERINATAL INTEST PERFOR 
7780 HYDROPS FETALIS NO ISOIM 
7790 CONVULSIONS IN NEWBORN 

7 791 NB CEREB IRRIT NEC/NOS 

7793 NB FEEDING PROBLEMS 

7794 NB DRUG REACTION/ INTOXIC 

7800 COMA AND STUPOR 

7801 HALLUCINATIONS 
7803 CONVULSIONS 
7817 TETANY 

7854 GANGRENE 

78550 SHOCK NOS 

78551 CARDIOGENIC SHOCK 
78559 SHOCK W/O TRAUMA NEC 
7863 HEMOPTYSIS 



7880 RENAL COLIC 

7882 RETENTION OF URINE 

7895 ASCITES 

7907 BACTEREMIA NOS 

7908 VI REM I A NOS 
7911 CHYLURIA 
7913 MYOGLOBINURIA 

7991 RESPIRATORY FAILURE 
7994 CACHEXIA 

80000 CLOSED SKULL VAULT FX 

80001 CL SKULL VLT FX W/O COMA 

80002 CL SKULL VLT FX-BRF COMA 

80003 CL SKULL VLT FX-MOD COMA 

80004 CL SKL VLT FX-PROLN COMA 

80005 CL SKUL VLT FX-DEEP COMA 

80006 CL SKULL VLT FX-COMA NOS 

80009 CL SKL VLT FX-CONCUS NOS 

80010 CL SKL VLT FX/CEREBR LAC 

80011 CL SKULL VLT FX W/O COMA 

80012 CL SKULL VLT FX-BRF COMA 

80013 CL SKULL VLT FX-MOD COMA 

80014 CL SKL VLT FX-PROLN COMA 

80015 CL SKUL VLT FX-DEEP COMA 

80016 CL SKULL VLT FX-COMA NOS 

80019 CL SKL VLT FX-CONCUS NOS 

80020 CL SKL VLT FX/MENING HEM 

80021 CL SKULL VLT FX W/O HEM 

80022 CL SKULL VLT FX-BRF COMA 

80023 CL SKULL VLT FX-MOD COMA 

80024 CL SKL VLT FX-PROLN COMA 

80025 CL SKUL VLT FX-DEEP COMA 

80026 CL SKULL VLT FX-COMA NOS 

80029 CL SKL VLT FX-CONCUS NOS 

80030 CL SKULL VLT FX/HEM NEC 

80031 CL SKULL VLT FX W/O COMA 

80032 CL SKULL VLT FX-BRF COMA 

80033 CL SKULL VLT FX-MOD COMA 

80034 CL SKL VLT FX-PROLN COMA 

80035 CL SKUL VLT FX-DEEP COMA 

80036 CL SKULL VLT FX-COMA NOS 

80039 CL SKL VLT FX-CONCUS NOS 

80040 CL SKL VLT FX/BR INJ NEC 

80041 CL SKULL VLT FX W/O COMA 

80042 CL SKULL VLT FX-BRF COMA 

80043 CL SKULL VLT FX-MOD COMA 

80044 CL SKL VLT FX-PROLN COMA 

80045 CL SKUL VLT FX-DEEP COMA 

80046 CL SKULL VLT FX-COMA NOS 

80049 CL SKL VLT FX-CONCUS NOS 

80050 OPN SKULL VAULT FRACTURE 

80051 OPN SKUL VLT FX W/O COMA 

80052 OPN SKUL VLT FX-BRF COMA 

80053 OPN SKUL VLT FX-MOD COMA 

80054 OPN SKL VLT FX-PROLN COM 



57 



Table 2.8— Continued 

ICD-9-CM diagnosis codes which represent substantial complications or comorbidities when present as 

secondary diagnoses 



80055 OPN SKL VLT FX-DEEP COMA 

80056 OPN SKUL VLT FX-COMA NOS 

80059 OP SKL VLT FX-CONCUS NOS 

80060 OPN SKL VLT FX/CEREB LAC 

80061 OPN SKUL VLT FX W/O COMA 

80062 OPN SKUL VLT FX-BRF COMA 

80063 OPN SKUL VLT FX-MOD COMA 

80064 OPN SKL VLT FX-PROLN COM 

80065 OPN SKL VLT FX-DEEP COMA 

80066 OPN SKUL VLT FX-COMA NOS 

80069 OP SKL VLT FX-CONCUS NOS 

80070 OPN SKL VLT FX/MENIN HEM 

80071 OPN SKUL VLT FX W/O COMA 

80072 OPN SKUL VLT FX-BRF COMA 

80073 OPN SKUL VLT FX-MOD COMA 

80074 OPN SKL VLT FX-PROLN COM 

80075 OPN SKL VLT FX-DEEP COMA 

80076 OPN SKUL VLT FX-COMA NOS 

80079 OP SKL VLT FX-CONCUS NOS 

80080 OPN SKULL VLT FX/HEM NEC 

80081 OPN SKUL VLT FX W/O COMA 

80082 OPN SKUL VLT FX-BRF COMA 

80083 OPN SKUL VLT FX-MOD COMA 

80084 OPN SKL VLT FX-PROLN COM 

80085 OPN SKL VLT FX-DEEP COMA 

80086 OPN SKUL VLT FX-COMA NOS 

80089 OP SKL VLT FX-CONCUS NOS 

80090 OP SKL VLT FX/BR INJ NEC 

80091 OPN SKUL VLT FX W/O COMA 

80092 OPN SKUL VLT FX-BRF COMA 

80093 OPN SKUL VLT FX-MOD COMA 

80094 OPN SKL VLT FX-PROLN COM 

80095 OP SKUL VLT FX-DEEP COMA 

80096 OPN SKUL VOT FX-COMA NOS 

80099 OP SKL VLT FX-CONCUS NOS 

80100 CLOS SKULL BASE FRACTURE 

80101 CL SKUL BASE FX W/O COMA 

80102 CL SKUL BASE FX-BRF COMA 

80103 CL SKUL BASE FX-MOD COMA 

80104 CL SKL BASE FX-PROL COMA 

80105 CL SKL BASE FX-DEEP COMA 

80106 CL SKUL BASE FX-COMA NOS 

80109 CL SKULL BASE FX-CONCUSS 

80110 CL SKL BASE FX/CEREB LAC 

80111 CL SKUL BASE FX W/O COMA 

80112 CL SKUL BASE FX-BRF COMA 

80113 CL SKUL BASE FX-MOD COMA 

80114 CL SKL BASE FX-PROL COMA 

80115 CL SKL BASE FX-DEEP COMA 

80116 CL SKUL BASE FX-COMA NOS 

80119 CL SKULL BASE FX-CONCUSS 

80120 CL SKL BASE FX/MENIN HEM 

80121 CL SKUL BASE FX W/O COMA 

80122 CL SKUL BASE FX/BRF COMA 



80123 CL SKUL BASE FX-MOD COMA 

80124 CL SKL BASE FX-PROL COMA 

80125 CL SKL BASE FX-DEEP COMA 

80126 CL SKUL BASE FX-COMA NOS 

80129 CL SKULL BASE FX-CONCUSS 

80130 CL SKULL BASE FX/HEM NEC 

80131 CL SKUL BASE FX W/O COMA 

80132 CL SKUL BASE FX-BRF COMA 

80133 CL SKUL BASE FX-MOD COMA 

80134 CL SKL BASE FX-PROL COMA 

80135 CL SKL BASE FX-DEEP COMA 

80136 CL SKUL BASE FX-COMA NOS 

80139 CL SKULL BASE FX-CONCUSS 

80140 CL SK BASE FX/BR INJ NEC 

80141 CL SKUL BASE FX W/O COMA 

80142 CL SKUL BASE FX-BRF COMA 

80143 CL SKUL BASE FX-MOD COMA 

80144 CL SKL BASE FX-PROL COMA 

80145 CL SKL BASE FX-DEEP COMA 

80146 CL SKUL BASE FX-COMA NOS 

80149 CL SKULL BASE FX-CONCUSS 

80150 OPEN SKULL BASE FRACTURE 

80151 OPN SKL BASE FX W/O COMA 

80152 OPN SKL BASE FX-BRF COMA 

80153 OPN SKL BASE FX-MOD COMA 

80154 OP SKL BASE FX-PROL COMA 

80155 OP SKL BASE FX-DEEP COMA 

80156 OPN SKL BASE FX-COMA NOS 

80159 OPN SKUL BASE FX-CONCUSS 

80160 OP SKL BASE FX/CEREB LAC 

80161 OPN SKL BASE FX W/O COMA 

80162 OPN SKL BASE FX-BRF COMA 

80163 OPN SKL BASE FX-MOD COMA 

80164 OP SKL BASE FX-PROL COMA 

80165 OP SKL BASE FX-DEEP COMA 

80166 OPN SKL BASE FX-COMA NOS 

80169 OPN SKUL BASE FX-CONCUSS 

80170 OP SKL BASE FX/MENIN HEM 

80171 OPN SKL BASE FX W/O CO*\ 

80172 OPN SKL BASE FX-BRF CO: . 

80173 OPN SKL BASE FX-MOD COMA 

80174 OP SKL BASE FX-PROL COMA 

80175 OP SKL BASE FX-DEEP COMA 

80176 OPN SKL BASE FX-COMA NOS 

80179 OPN SKUL BASE FX-CONCUSS 

80180 OPN SKUL BASE FX/HEM NEC 

80181 OPN SKL BASE FX W/O COMA 

80182 OPN SKL BASE FX-BRF COMA 

80183 OPN SKL BASE FX-MOD COMA 

80184 OP SKL BASE FX-PROL COMA 

80185 OP SKL BASE FX-DEEP COMA 

80186 OPN SKL BASE FX-COMA NOS 

80189 OPN SKUL BASE FX-CONCUSS 

80190 OP SK BASE FX/BR INJ NEC 



58 



Table 2.8— Continued 

ICD-9-CM diagnosis codes which represent substantial complications or comorbidities when present as 

secondary diagnoses 



80191 OP SKUL BASE FX W/0 COMA 80324 

80192 OPN SKL BASE FX-BRF COMA 80325 

80193 OPN SKL BASE FX-MOD COMA 80326 

80194 OP SKL BASE FX-PROL COMA 80329 

80195 OP SKL BASE FX-DEEP COMA 80330 

80196 OPN SKL BASE FX-COMA NOS 80331 
80199 OPN SKUL BASE FX-CONCUSS 80332 
8021 NASAL BONE FX-OPEN 80333 

80220 MANDIBLE FX NOS-CLOSED 80334 

80221 FX CONDYL PROC MANDIB-CL 80335 

80222 SUBCONDYLAR FX MANDIB-CL 80336 

80223 FX CORON PROC MANDIB-CL 80339 

80224 FX RAMUS NOS-CLOSED 80340 

80225 FX ANGLE OF JAW-CLOSED 80341 

80226 FX SYMPHY MANDIB BODY-CL 80342 

80227 FX ALVEOLAR BORD MAND-CL 80343 

80228 FX MANDIBLE BODY NEC-CL 80344 

80229 MULT FX MANDIBLE -CLOSED 80345 

80230 MANDIBLE FX NOS-OPEN 80346 

80231 FX CONDYL PROC MAND-OPEN 80349 

80232 SUBCONDYL FX MANDIB-OPEN 80350 

80233 FX CORON PROC MANDIB-OPN 80351 

80234 FX RAMUS NOS-OPEN 80352 

80235 FX ANGLE OF JAW-OPEN 80353 

80236 FX SYMPHY MANDIB BDY-OPN 80354 

80237 FX ALV BORD MAND BDY-OPN 80355 

80238 FX MANDIBLE BODY NEC-OPN 80356 

80239 MULT FX MANDIBLE-OPEN 80359 

8024 FX MALAR/MAXILLARY-CLOSE 80360 

8025 FX MALAR/MAXILLARY-OPEN 80361 

8026 FX ORBITAL FLOOR-CLOSED 80362 

8027 FX ORBITAL FLOOR-OPEN 80363 

8028 FX FACIAL BONE NEC-CLOSE 80364 

8029 FX FACIAL BONE NEC-OPEN 80365 

80300 CLOSE SKULL FRACTURE NEC 80366 

80301 CL SKULL FX NEC W/O COMA 80369 

80302 CL SKULL FX NEC-BRF COMA 80370 

80303 CL SKULL FX NEC-MOD COMA 80371 

80304 CL SKL FX NEC-PROLN COMA 80372 

80305 CL SKUL FX NEC-DEEP COMA 80373 

80306 CL SKULL FX NEC-COMA NOS 80374 

80309 CL SKULL FX NEC-CONCUSS 80375 

80310 CL SKL FX NEC/CEREBR LAC 80376 

80311 CL SKULL FX NEC W/O COMA 80379 

80312 CL SKULL FX NEC-BRF COMA 80380 

80313 CL SKULL FX NEC-MOD COMA 80381 

80314 CL SKL FX NEC-PROLN COMA 80382 

80315 CL SKUL FX '.'EC-DEEP COMA 80383 

80316 CL SKULL FX NEC-COMA NOS 80384 

80319 CL SKULL FX NEC-CONCUSS 80385 

80320 CL SKL FX NEC/MENING HEM 80386 

80321 CL SKULL FX NEC W/O COMA 80389 

80322 CL SKULL FX NEC-BRF COMA 80390 

80323 CL SKULL FX NEC-MOD COMA 80391 



CL SKL FX NEC-PROLN COMA 
CL SKUL FX NEC -DEEP COMA 
CL SKULL FX NEC -COMA NOS 
CL SKULL FX NEC -CONCUSS 
CL SKULL FX NEC /HEM NEC 
CL SKULL FX NEC W/O COMA 
CL SKULL FX NEC-BRF COMA 
CL SKULL FX NEC -MOD COMA 
CL SKL FX NEC-PROLN COMA 
CL SKUL FX NEC -DEEP COMA 
CL SKULL FX NEC -COMA NOS 
CL SKULL FX NEC-CONCUSS 
CL SKL FX NEC/BR INJ NEC 
CL SKULL FX NEC W/O COMA 
CL SKULL FX NEC-BRF COMA 
CL SKULL FX NEC -MOD COMA 
CL SKL FX NEC-PROLN COMA 
CL SKUL FX NEC -DEEP COMA 
CL SKULL FX NEC -COMA NOS 
CL SKULL FX NEC -CONCUSS 
OPEN SKULL FRACTURE NEC 
OPN SKUL FX NEC W/O COMA 
OPN SKUL FX NEC-BRF COMA 
OPN SKUL FX NEC -MOD COMA 
OPN SKL FX NEC-PROL COMA 
OPN SKL FX NEC-DEEP COMA 
OPN SKUL FX NEC -COMA NOS 
OPN SKULL FX NEC-CONCUSS 
OPN SKL FX NEC/CEREB LAC 
OPN SKUL FX NEC W/O COMA 
OPN SKUL FX NEC-BRF COMA 
OPN SKUL FX NEC -MOD COMA 
OPN SKL FX NEC-PROLN COM 
OPN SKL FX NEC -DEEP COMA 
OPN SKUL FX NEC -COMA NOS 
OPN SKULL FX NEC-CONCUSS 
OPN SKL FX NEC/MENIN HEM 
OPN SKUL FX NEC W/O COMA 
OPN SKUL FX NEC-BRF COMA 
OPN SKUL FX NEC -MOD COMA 
OPN SKL FX NEC-PROL COMA 
OPN SKL FX NEC-DEEP COMA 
OPN SKUL FX NEC -COMA NOS 
OPN SKULL FX NEC -CONCUSS 
OPN SKULL FX NEC/HEM NEC 
OPN SKUL FX NEC W/O COMA 
OPN SKUL FX NEC-BRF COMA 
OPN SKUL FX NEC-MOD COMA 
OPN SKL FX NEC-PROL COMA 
OPN SKL FX NEC-DEEP COMA 
OPN SKUL FX NEC -COMA NOS 
OPN SKULL FX NEC-CONCUSS 
OP SKL FX NEC/BR INJ NEC 
OPN SKUL FX NEC W/O COMA 



59 



Table 2.8— Continued 

ICD-9-CM diagnosis codes which represent substantial complications or comorbidities when present as 

secondary diagnoses 



80392 OPN SKUL FX NEC-BRF COMA 

80393 OPN SKUL FX NEC -MOD COMA 

80394 OPN SKL FX NEC-PROL COMA 

80395 OPN SKL FX NEC-DEEP COMA 

80396 OPN SKUL FX NEC-COMA N0S 

80399 OPN SKULL FX NEC-CONCUSS 

80400 CL SKUL FX W OTH BONE FX 

80401 CL SKL W OTH FX W/O COMA 

80402 CL SKL tf OTH FX-BRF COMA 

80403 CL SKL W OTH FX-MOD COMA 

80404 CL SKL/OTH FX-PROLN COMA 

80405 CL SKUL/OTH FX-DEEP COMA 

80406 CL SKL W OTH FX-COMA NOS 

80409 CL SKUL W OTH FX-CONCUSS 

80410 CL SK W OTH FX/CEREB LAC 

80411 CL SKL W OTH FX W/0 COMA 

80412 CL SKL W OTH FX-BRF COMA 

80413 CL SKL tf OTH FX-MOD COMA 

80414 CL SKL/OTH FX-PROLN COMA 

80415 CL SKUL/OTH FX-DEEP COMA 

80416 CL SKL W OTH FX-COMA NOS 

80419 CL SKUL W OTH FX-CONCUSS 

80420 CL SKL/OTH FX/MENING HEM 

80421 CL SKL W OTH FX W/O COMA 

80422 CL SKL W OTH FX-BRF COMA 

80423 CL SKL W OTH FX-MOD COMA 

80424 CL SKL/OTH FX-PROLN COMA 

80425 CL SKUL/OTH FX-DEEP COMA 

80426 CL SKL W OTH FX-COMA NOS 

80429 CL SKUL tf OTH FX-CONCUSS 

80430 CL SKUL W OTH FX/HEM NEC 

80431 CL SKL W OTH FX W/O COMA 

80432 CL SKL W OTH FX-BRF COMA 

80433 CL SKL W OTH FX-MOD COMA 

80434 CL SKL/OTH FX-PROLN COMA 

80435 CL SKUL/OTH FX-DEEP COMA 

80436 CL SKL W OTH FX-COMA NOS 

80439 CL SKUL W OTH FX-CONCUSS 

80440 CL SKL/OTH FX/BR INJ NEC 

80441 CL SKL W OTH FX W/O COMA 

80442 CL SKL W OTH FX-BRF COMA 

80443 CL SKL W OTH FX-MOD COMA 

80444 CL SKL/OTH FX-PROLN COMA 

80445 CL SKUL/OTH FX-DEEP COMA 

80446 CL SKL W OTH FX-COMA NOS 

80449 CL SKUL W OTH FX-CONCUSS 

80450 OPN SKULL FX/OTH BONE FX 

80451 OPN SKUL/OTH FX W/O COMA 

80452 OPN SKUL/OTH FX-BRF COMA 

80453 OPN SKUL/OTH FX-MOD COMA 

80454 OPN SKL/OTH FX-PROL COMA 

80455 OPN SKL/OTH FX-DEEP COMA 

80456 OPN SKUL/OTH FX-COMA NOS 
80459 OPN SKULL/OTH FX-CONCUSS 



80460 OPN SKL/OTH FX/CEREB LAC 

80461 OPN SKUL/OTH FX W/O COMA 

80462 OPN SKUL/OTH FX-BRF COMA 

80463 OPN SKUL/OTH FX-MOD COMA 

80464 OPN SKL/OTH FX-PROL COMA 

80465 OPN SKL/OTH FX-DEEP COMA 

80466 OPN SKUL/OTH FX-COMA NOS 

80469 OPN SKULL/OTH FX-CONCUSS 

80470 OPN SKL/OTH FX/MENIN HEM 

80471 OPN SKUL/OTH FX W/O COMA 

80472 OPN SKUL/OTH FX-BRF COMA 

80473 OPN SKUL/OTH FX-MOD COMA 

80474 OPN SKL/OTH FX-PROL COMA 

80475 OPN SKL/OTH FX-DEEP COMA 

80476 OPN SKUL/OTH FX-COMA NOS 

80479 OPN SKULL/OTH FX-CONCUSS 

80480 OPN SKL W OTH FX/HEM NEC 

80481 OPN SKUL/OTH FX W/O COMA 

80482 OPN SKUL/OTH FX-BRF COMA 

80483 OPN SKUL/OTH FX-MOD COMA 

80484 OPN SKL/OTH FX-PROL COMA 

80485 OPN SKL/OTH FX-DEEP COMA 

80486 OPN SKUL/OTH FX-COMA NOS 

80489 OPN SKULL/OTH FX-CONCUSS 

80490 OP SKL/OTH FX/BR INJ NEC 

80491 OPN SKUL/OTH FX W/O COMA 

80492 OPN SKUL/OTH FX-BRF COMA 

80493 OPN SKUL/OTH FX-MOD COMA 

80494 OPN SKL/OTH FX-PROL COMA 

80495 OPN SKL/OTH FX-DEEP COMA 

80496 OPN SKUL/OTH FX-COMA NOS 

80499 OPN SKULL/OTH FX-CONCUSS 

80500 FX CERVICAL VERT NOS-CL 

80501 FX CI VERTEBRA-CLOSED 

80502 FX C2 VERTEBRA-CLOSED 

80503 FX C3 VERTEBRA-CLOSED 

80504 FX C4 VERTEBRA-CLOSED 

80505 FX C5 VERTEBRA-CLOSED 

80506 FX C6 VERTEBRA -CLOSED 

80507 FX C7 VERTEBRA-CLOSED 

80508 FX MULT CERVICAL VERT-CL 

80510 FX CERVICAL VERT NOS-OPN 

80511 FX CI VERTEBRA-OPEN 

80512 FX C2 VERTEBRA-OPEN 

80513 FX C3 VERTEBRA-OPEN 

80514 FX C4 VERTEBRA-OPEN 

80515 FX C5 VERTEBRA-OPEN 

80516 FX C6 VERTEBRA-OPEN 

80517 FX C7 VERTEBRA-OPEN 

80518 FX MLT CERVICAL VERT-OPN 

8052 FX DORSAL VERTEBRA-CLOSE 

8053 FX DORSAL VERTEBRA-OPEN 

8054 FX LUMBAR VERTEBRA-CLOSE 

8055 FX LUMBAR VFi- TEBRA-OPEN 



60 



Table 2.8— Continued 

ICD-9-CM diagnosis codes which represent substantial complications or comorbidities when present as 

secondary diagnoses 



8056 FX SACRUM/COCCYX-CLOSED 

8057 FX SACRUM/COCCYX-OPEN 

8058 VERTEBRAL FX NOS-CLOSED 

8059 VERTEBRAL FX NOS -OPEN 

80600 C1-C4 FX-CL/CORD INJ NOS 

80601 C1-C4 FX-CL/COM CORD LES 

80602 C1-C4 FX-CL/ANT CORD SYN 

80603 C1-C4 FX-CL/CEN CORD SYN 

80604 C1-C4 FX-CL/CORD INJ NEC 

80605 C5-C7 FX-CL/CORD INJ NOS 

80606 C5-C7 FX-CL/COM CORD LES 

80607 C5-C7 FX-CL/ANT CORD SYN 

80608 C5-C7 FX-CL/CEN CORD SYN 

80609 C5-C7 FX-CL/CORD INJ NEC 

80610 C1-C4 FX-OP/CORD INJ NOS 

80611 C1-C4 FX-OP/COM CORD LES 

80612 C1-C4 FX-OP/ANT CORD SYN 

80613 C1-C4 FX-OP/CEN CORD SYN 

80614 C1-C4 FX-OP/CORD INJ NEC 

80615 C5-C7 FX-OP/CORD INJ NOS 

80616 C5-C7 FX-OP/COM CORD LES 

80617 C5-C7 FX-OP/ANT CORD SYN 

80618 C5-C7 FX-OP/CEN CORD SYN 

80619 C5-C7 FX-OP/CORD INJ NEC 

80620 T1-T6 FX-CL/CORD INJ NOS 

80621 T1-T6 FX-CL/COM CORD LES 

80622 T1-T6 FX-CL/ANT CORD SYN 

80623 T1-T6 FX-CL/CEN CORD SYN 

80624 T1-T6 FX-CL/CORD INJ NEC 

80625 T7-T12 FX-CL/CRD INJ NOS 

80626 T7-T12 FX-CL/COM CRD LES 

80627 T7-T12 FX-CL/ANT CRD SYN 

80628 T7-T12 FX-CL/CEN CRD SYN 

80629 T7-T12 FX-CL/CRD INJ NEC 

80630 T1-T6 FX-OP/CORD INJ NOS 

80631 T1-T6 FX-OP/COM CORD LES 

80632 T1-T6 FX-OP/ANT CORD SYN 

80633 T1-T6 FX-OP/CEN CORD SYN 

80634 T1-T6 FX-OP/CORD INJ NEC 

80635 T7-T12 FX-OP/CRD INJ NOS 

80636 T7-T12 FX-OP/COM CRD LES 

80637 T7-T12 FX-OP/ANT CRD SYN 

80638 T7-T12 FX-OP/CEN CRD SYN 

80639 T7-T12 FX-OP/CRD TNJ NEC 

8064 CL LUMBAR FX W CORD INJ 

8065 OPN LUMBAR FX W CORD INJ 

80660 FX SACRUM-CL/CRD INJ NOS 

80661 FX SACR-CL/CAUDA EQU LES 

80662 FX SACR-CL/CAUDA INJ NEC 

80669 FX SACRUM-CL/CRD INJ NEC 

80670 FX SACRUM-OP/CRD INJ NOS 

80671 FX SACR-OP/CAUDA EQU LES 

80672 FX SACR-OP/CAUDA INJ NEC 
80679 FX SACRUM-OP/CRD INJ NEC 



8068 VERT FX NOS-CL W CRD INJ 

8069 VERT FX NOS -OP W CRD INJ 

80704 FRACTURE FOUR RIBS-CLOSE 

80705 FRACTURE FIVE RIBS-CLOSE 

80706 FRACTURE SIX RIBS-CLOSED 

80707 FRACTURE SEVEN RIBS-CLOS 

80708 FX EIGHT/MORE RIB-CLOSED 

80709 FX MULT RIBS NOS-CLOSED 

80710 FRACTURE RIB NOS -OPEN 

80711 FRACTURE ONE RIB -OPEN 

80712 FRACTURE TWO RIBS -OPEN 

80713 FRACTURE THREE RIBS-OPEN 

80714 FRACTURE FOUR RIBS -OPEN 

80715 FRACTURE FIVE RIBS-OPEN 

80716 FRACTURE SIX RIBS-OPEN 

80717 FRACTURE SEVEN RIBS-OPEN 

80718 FX EIGHT/MORE RIBS-OPEN 

80719 FX MULT RIBS NOS-OPEN 

8072 FRACTURE OF STERNUM-CLOS 

8073 FRACTURE OF STERNUM-OPEN 

8074 FLAIL CHEST 

8075 FX LARYNX/TRACHEA-CLOSED 

8076 FX LARYNX/TRACHEA -OPEN 

8080 FRACTURE ACETABULUM-CLOS 

8081 FRACTURE ACETABULUM -OPEN 

8082 FRACTURE OF PUB IS -CLOSED 

8083 FRACTURE OF PUBIS -OPEN 
80843 PELV FX-CLOS/PELV DISRUP 
80849 PELVIC FRACTURE NEC-CLOS 

80851 FRACTURE OF ILIUM-OPEN 

80852 FRACTURE OF ISCHIUM-OPEN 

80853 PELV FX-OPEN/PELV DISRUP 
80859 PELVIC FRACTURE NEC-OPEN 

8088 PELVIC FRACTURE NOS-CLOS 

8089 PELVIC FRACTURE NOS-OPEN 

82000 FX FEMUR INTRCAPS NOS-CL 

82001 FX UP FEMUR EPIPHY-CLOS 

82002 FX FEMUR, MIDCERVIC-CLOS 

82003 FX BASE FEMORAL NCK-CLOS 

82009 FX FEMUR INTRCAPS NEC-CL 

82010 FX FEMUR INTRCAP NOS -OPN 

82011 FX UP FEMUR EPIPHY-OPEN 

82012 FX FEMUR, MIDCERVIC-OPEN 

82013 FX BASE FEMORAL NCK-OPEN 

82019 FX FEMUR INTRCAP NEC -OPN 

82020 TROCHANTERIC FX NOS-CtOS 

82021 INTERTROCHANTERIC FX-CL 

82022 SUBTROCHANTERIC FX-CLOSE 

82030 TROCHANTERIC FX NOS-OPEN 

82031 INTERTROCHANTERIC FX-OPN 

82032 SUBTROCHANTERIC FX-OPEN 

8208 FX NECK OF FEMUR NOS-CL 

8209 FX NECK OF FEMUR NOS -OPN 
82100 FX FEMUR NOS-CLOSED 



61 



Table 2.8— Continued 

ICD-9-CM diagnosis codes which represent substantial complications or comorbidities when present as 

secondary diagnoses 



82101 FX FEMUR SHAFT-CLOSED 85131 

82110 FX FEMUR NOS-OPEN 85132 

82111 FX FEMUR SHAFT-OPEN 85133 
83819 DISLOCAT FOOT NEC-OPEN 85134 

83900 DISLOC CERV VERT NOS-CL 85135 

83901 DISLOC 1ST CERV VERT-CL 85136 

83902 DISLOC 2ND CERV VERT-CL 85139 

83903 DISLOC 3RD CERV VERT-CL 85140 

83904 DISLOC 4TH CERV VERT-CL 85141 

83905 DISLOC 5TH CERV VERT-CL 85142 

83906 DISLOC 6TH CERV VERT-CL 85143 

83907 DISLOC 7TH CERV VERT-CL 85144 

83908 DISLOC MULT CERV VERT-CL 85145 

83910 DISLOC CERV VERT NOS-OPN 85146 

83911 DISLOC LST CERV VERT-OPN 85149 

83912 DISLOC 2ND CERV VERT-OPN 85150 

83913 DISLOC 3RD CERV VERT-OPN 85151 

83914 DISLOC 4TH CERV VERT-OPN 85152 

83915 DISLOC 5TH CERV VERT-OPN 85153 

83916 DISLOC 6TH CERV VERT-OPN 85154 

83917 DISLOC 7TH CERV VERT-OPN 85155 

83918 DISLOC MLT CERV VERT-OPN 85156 

8500 CONCUSSION W/O COMA 85159 

8501 CONCUSSION-BRIEF COMA 85160 

8502 CONCUSSION-MODERATE COMA 85161 

8503 CONCUSSION-PROLONG COMA 85162 

8504 CONCUSSION-DEEP COMA 85163 

8505 CONCUSSION W COMA NOS 85164 
8509 CONCUSSION NOS 85165 

85100 CEREBRAL CORTX CONTUSION 85166 

85101 CORTEX CONTUSION-NO COMA 85169 

85102 CORTEX CONTUS-BRIEF COMA 85170 

85103 CORTEX CONTUS-MOD COMA 85171 

85104 CORTX CONTUS-PROLNG COMA 85172 

85105 CORTEX CONTUS-DEEP COMA 85173 

85106 CORTEX CONTUS-COMA NOS 85174 

85109 CORTEX CONTUS-CONCUS NOS 85175 

85110 CORTEX CONTUSION/OPN WND 85176 

85111 OPN CORTX CONTUS-NO COMA 85179 

85112 OPN CORT CONTUS-BRF COMA 85180 

85113 OPN CORT CONTUS-MOD COMA 85181 

85114 OPN CORT CONTU-PROL COMA 85182 

85115 OPN CORT CONTU-DEEP COMA 85183 

85116 OPN CORT CONTUS-COMA NOS 85184 

85119 OPN CORTX CONTUS -CONCUSS 85185 

85120 CEREBRAL CORTEX LACERAT 85186 

85121 CORTEX LACERAT W/O COMA 85189 

85122 CORTEX LACERA-BRIEF COMA 85190 

85123 CORTEX LACERAT-MOD COMA 85191 

85124 CORTEX LACERAT-PROL COMA 85192 

85125 CORTEX LACERAT-DEEP COMA 85193 

85126 CORTEX LACERAT-COMA NOS 85194 

85129 CORTEX LACERAT -CONCUSS 85195 

85130 CORTEX LACER W OPN WOUND 85196 



OPN CORTEX LACER -NO COMA 
OPN CORTX LAC-BRIEF COMA 
OPN CORTX LACER-MOD COMA 
OPN CORTX LAC-PROLN COMA 
OPN CORTEX LAC -DEEP COMA 
OPN CORTX LACER-COMA NOS 
OPN CORTX LACER-CONCUSS 
CEREBEL/BRAIN STM CONTUS 
CEREBELL CONTUS W/O COMA 
CEREBELL CONTUS-BRF COMA 
CEREBELL CONTUS-MOD COMA 
CEREBEL CONTUS-PROL COMA 
CEREBEL CONTUS-DEEP COMA 
CEREBELL CONTUS-COMA NOS 
CEREBELL CONTUS -CONCUSS 
CEREBEL CONTUS W OPN WND 
OPN CEREBE CONT W/O COMA 
OPN CEREBE CONT-BRF COMA 
OPN CEREBE CONT-MOD COMA 
OPN CEREBE CONT-PROL COM 
OPN CEREBE CONT-DEEP COM 
OPN CEREBE cONT-COMA NOS 
OPN CEREBEL CONT-CONCUSS 
CEREBEL/BRAIN STEM LACER 
CEREBEL LACERAT W/O COMA 
CEREBEL LACER-BRIEF COMA 
CEREBEL LACERAT-MOD COMA 
CEREBEL LACER-PROLN COMA 
CEREBELL LACER-DEEP COMA 
CEREBEL LACERAT-COMA NOS 
CEREBEL LACER-CONCUSSION 
CEREBEL LACER W OPEN WND 
OPN CEREBEL LAC W/O COMA 
OPN CEREBEL LAC-BRF COMA 
OPN CEREBEL LAC-MOD COMA 
OPN CEREBE LAC-PROL COMA 
OPN CEREBE LAC -DEEP COMA 
OPN CEREBEL LAC-COMA NOS 
OPN CEREBELL LAC-CONCUSS 
BRAIN LACERATION NEC 
BRAIN LACER NEC W/O COMA 
BRAIN LAC NEC-BRIEF COMA 
BRAIN LACER NEC-MOD COMA 
BRAIN LAC NEC-PROLN COMA 
BRAIN LAC NEC-DEEP COMA 
BRAIN LACER NEC-COMA NOS 
BRAIN LACER NEC-CONCUSS 
BRAIN LAC NEC W OPEN WND 
OPN BRAIN LACER W/O COMA 
OPN BRAIN LAC-BRIEF COMA 
OPN BRAIN LACER-MOD COMA 
OPN BRAIN LAC-PROLN COMA 
OPEN BRAIN LAC-DEEP COMA 
OPN BRAIN LACER-COMA NOS 



62 



Table 2.8— Continued 

ICD-9-CM diagnosis codes which represent substantial complications or comorbidities when present as 

secondary diagnoses 



85199 OPEN BRAIN LACER-CONCUSS 

85200 TRAUM SUBARACHNOID HEM 

85201 SUBARACHNOID HEM-NO COMA 

85202 SUBARACH HEM-BRIEF COMA 

85203 SUBARACH HEM-MOD COMA 

85204 SUBARACH HEM-PR0LNG COMA 

85205 SUBARACH HEM-DEEP COMA 

85206 SUBARACH HEM-COMA NOS 

85209 SUBARACH HEM-CONCUSSION 

85210 SUBARACH HEM W OPN WOUND 

85211 OPN SUBARACH HEM-NO COMA 

85212 OP SUBARACH HEM-BRF COMA 

85213 OP SUBARACH HEM-MOD COMA 

85214 OP SUBARACH HEM-PROL COM 

85215 OP SUBARACH HEM-DEEP COM 

85216 OP SUBARACH HEM-COMA NOS 

85219 OPN SUBARACH HEM-CONCUSS 

85220 TRAUMATIC SUBDURAL HEM 

85221 SUBDURAL HEM W/O COMA 

85222 SUBDURAL HEM-BRIEF COMA 

85223 SUBDURAL HEMORR-MOD COMA 

85224 SUBDURAL HEM-PROLNG COMA 

85225 SUBDURAL HEM-DEEP COMA 

85226 SUBDURAL HEMORR-COMA NOS 

85229 SUBDURAL HEM -CONCUSS ION 

85230 SUBDURAL HEM W OPN WOUND 

85231 OPEN SUBDUR HEM W/O COMA 

85232 OPN SUBDUR HEM-BRF COMA 

85233 OPN SUBDUR HEM-MOD COMA 

85234 OPN SUBDUR HEM-PROL COMA 

85235 OPN SUBDUR HEM-DEEP COMA 

85236 OPN SUBDUR HEM-COMA NOS 

85239 OPN SUBDUR HEM-CONCUSS 

85240 TRAUMATIC EXTRADURAL HEM 

85241 EXTRADURAL HEM W/O COMA 

85242 EXTRADUR HEM-BRIEF COMA 

85243 EXTRADURAL HEM-MOD COMA 

85244 EXTRADUR HEM-PROLN COMA 

85245 EXTRADURAL HEM-DEEP COMA 

85246 EXTRADURAL HEM-COMA NOS 

85249 EXTADURAL HEM-CONCUSS 

85250 EXTRADURAL HEM W OPN WND 

85251 EXTRADURAL HEMOR-NO COMA 

85252 EXTRADUR HEM-BRIEF COMA 

85253 EXTRADURAL HEM -MOD COMA 

85254 EXTRADUR HEM-PROLN COMA 

85255 EXTRADUR H..M-DEEP COMA 

85256 EXTRADURAL HEM-COMA NOS 
85259 EXTRADURAL HEM-CONCUSS 

85300 TRAUMATIC BRAIN HEM NEC 

85301 BRAIN HEM NEC W/O COMA 

85302 BRAIN HEM NEC-BRIEF COMA 

85303 BRAIN HEM NEC-MOD COMA 

85304 BRAIN HEM NEC-PROLN COMA 



85305 BRAIN HEM NEC-DEEP COMA 

85306 BRAIN HEM NEC-COMA NOS 

85309 BRAIN HEM NEC-CONCUSSION 

85310 BRAIN HEM NEC W OPN WND 

85311 BRAIN HEM OPN W/O COMA 

85312 BRAIN HEM OPN-BRF COMA 

85313 BRAIN HEM OPEN-MOD COMA 

85314 BRAIN HEM OPN-PROLN COMA 

85315 BRAIN HEM OPEN-DEEP COMA 

85316 BRAIN HEM OPEN-COMA NOS 
85319 BRAIN HEM OPN-CONCUSSION 

85400 BRAIN INJURY NEC 

85401 BRAIN INJURY NEC-NO COMA 

85402 BRAIN INJ NEC-BRIEF COMA 

85403 BRAIN INJ NEC-MOD COMA 

85404 BRAIN INJ NEC-PROLN COMA 

85405 BRAIN INJ NEC-DEEP COMA 

85406 BRAIN INJ NEC-COMA NOS 

85409 BRAIN INJ NEC-CONCUSSION 

85410 BRAIN INJURY W OPN WND 

85411 OPN BRAIN INJ W/O COMA 

85412 OPN BRAIN INJ-BRIEF COMA 

85413 OPN BRAIN INJ-MOD COMA 

85414 OPN BRAIN INJ-PROLN COMA 

85415 OPN BRAIN INJ-DEEP COMA 

85416 OPEN BRAIN INJ-COMA NOS 
85419 OPN BRAIN INJ-CONCUSSION 

8600 TRAUM PNEUMOTHORAX-CLOSE 

8601 TRAUM PNEUMOTHORAX-OPEN 

8602 TRAUM HEMOTHORAX -CLOSED 

8603 TRAUM HEMOTHORAX -OPEN 

8604 TRAUM PNEUMOHEMOTHOR-CL 

8605 TRAUM PNEUMOHEMOTHOR-OPN 

86101 HEART CONTUSION-CLOSED 

86102 HEART LACERATION-CLOSED 

86103 HEART CHAMBER LACERAT-CL 

86110 HEART INJURY NOS -OPEN 

86111 HEART CONTUSION-OPEN 

86112 HEART LACERATION -OPEN 

86113 HEART CHAMBER LACER-OPN 
86122 LUNG LACERATION-CLOSED 

86130 LUNG INJURY NOS-OPEN 

86131 LUNG CONTUSION-OPEN 

86132 LUNG LACERATION-OPEN 
8621 DIAPHRAGM INJURY-OPEN 

86221 BRONCHUS INJURY-CLOSED 

86222 ESOPHAGUS INJURY-CLOSED 
86229 INTRATHORACIC INJ NEC-CL 

86231 BRONCHUS INJURY-OPEN 

86232 ESOPHAGUS INJURY-OPEN 
86239 INTRATHORAC INJ NEC-OPEN 
8629 INTRATHORAC INJ NOS-OPEN 
8631 STOMACH INJURY-OPEN 
86330 SMALL INTEST INJ NOS-OPN 



63 



Table 2.8— Continued 

ICD-9-CM diagnosis codes which represent substantial complications or comorbidities when present as 

secondary diagnoses 



86331 DUODENUM INJURY-OPEN 
86339 SMALL INTEST INJ NEC-OPN 

86350 COLON INJURY N0S-0PEN 

86351 ASCENDING COLON INJ-OPEN 

86352 TRANSVERSE COLON INJ-OPN 

86353 DESCENDING COLON INJ-OPN 

86354 SIGMOID COLON INJ-OPEN 

86355 RECTUM INJURY-OPEN 

86356 COLON INJ MULT SITE-OPEN 
86359 COLON INJURY NEC-OPEN 

86390 GI INJURY NOS-OPEN 

86391 PANCREAS, HEAD INJ-OPEN 

86392 PANCREAS, BODY INJ-OPEN 

86393 PANCREAS, TAIL INJ-OPEN 

86394 PANCREAS INJURY NOS-OPEN 

86395 APPENDIX INJURY-OPEN 

86399 GI INJURY NEC -OPEN 

86400 LIVER INJURY NOS -CLOSED 

86401 LIVER HEMATOMA/CONTUS ION 

86402 LIVER LACERATION, MINOR 

86403 LIVER LACERATION, MOD 

86404 LIVER LACERATION, MAJOR 

86409 LIVER INJURY NEC-CLOSED 

86410 LIVER INJURY NOS-OPEN 

86411 LIVER HEMATOM/CONTUS-OPN 

86412 LIVER LACERAT, MINOR-OPN 

86413 LIVER LACERAT, MOD-OPEN 

86414 LIVER LACERAT, MAJOR-OPN 
86419 LIVER INJURY NEC -OPEN 

86500 SPLEEN INJURY NOS-CLOSED 

86501 SPLEEN HEMATOMA-CLOSED 

86502 SPLEEN CAPSULAR TEAR 

86503 SPLEEN PARENCHYMA LACER 

86504 SPLEEN DISRUPTION-CLOS 

86509 SPLEEN INJURY NEC-CLOSED 

86510 SPLEEN INJURY NOS-OPEN 

86511 SPLEEN HEMATOMA-OPEN 

86512 SPLEEN CAPSULAR TEAR-OPN 

86513 SPLEEN PARNCHYM LAC-OPN 

86514 SPLEEN DISRUPTION-OPEN 
86519 SPLEEN INJURY NEC -OPEN 

86600 KIDNEY INJURY NOS-CLOSED 

86601 KIDNEY HEMATOMA-CLOSED 

86602 KIDNEY LACERATION-CLOSED 

86603 KIDNEY DISRUPTION-CLOSED 

86610 KIDNEY INJURY NOS-OPEN 

86611 KIDNEY HEMATOMA-OPEN 

86612 KIDNEY LACERAT ION -OPEN 

86613 KIDNEY DISRUPTION-OPEN 

8670 BLADDER/URETHRA INJ-CLOS 

8671 BLADDER/URETHRA INJ-OPEN 

8672 URETER INJURY-CLOSED 

8673 URETER INJURY-OPEN 

8674 UTERUS INJURY-CLOSED 



8675 UTERUS INJURY-OPEN 

8676 PELVIC ORGAN INJ NEC-CL 

8676 PELVIC ORGAN INJ NEC-CL 

8677 PELVIC ORGAN INJ NEC-OPN 

8677 PELVIC ORGAN INJ NEC-OPN 

8678 PELVIC ORGAN INJ NOS-CL 

8678 PELVIC ORGAN INJ NOS-CL 

8679 PELVIC ORGAN INJ NOS-OPN 
8679 PELVIC ORGAN INJ NOS-OPN 

86800 INTRA-ABDOM INJ NOS-CLOS 

86801 ADRENAL GLAND INJURY-CL 

86802 BILIARY TRACT INJURY-CL 

86803 PERITONEUM INJURY-CLOSED 

86804 RETROPER ITONEUM INJ-CL 

86809 INTRA-ABDOM INJ NEC-CLOS 

86810 INTRA-ABDOM INJ NOS-OPEN 

86811 ADRENAL GLAND INJURY-OPN 

86812 BILIARY TRACT INJURY-OPN 

86813 PERITONEUM INJURY-OPEN 

86814 RETROPER ITONEUM INJ-OPEN 
86819 INTRA-ABDOM INJ NEC-OPEN 

8690 INTERNAL INJ' NOS-CLOSED 

8691 INTERNAL INJURY NOS-OPEN 

8703 PENETR WND ORBIT W/O FB 

8704 PENETRAT WND ORBIT W FB 

8708 OPN WND OCULAR ADNEX NEC 

8709 OPN WND OCULAR ADNEX NOS 

8710 OCULAR LAC W/O PROLAPSE 

8711 OCULAR LACERA W PROLAPSE 

8712 RUPTURE EYE W TISSU LOSS 

8713 AVULSION OF EYE 

8714 LACERATION OF EYE NOS 
8719 OPN WOUND OF EYEBALL NOS 
87 39 OPEN WND HEAD NEC-COMPL 

87400 OPN WND LARYNX W TRACHEA 

87401 OPEN WOUND OF LARYNX 

87402 OPEN WOUND OF TRACHEA 

87410 OPN WND LARY W TRAC-COMP 

87411 OPEN WOUND LARYNX-COMPL 

87412 OPEN WOUND TRACHEA-COMPL 

8750 OPEN WOUND OF CHEST 

8751 OPEN WOUND CHEST-COMPL 

90000 INJUR CAROTID ARTERY NOS 

90001 INJ COMMON CAROTID ARTER 

90002 INJ EXTERNAL CAROTID ART 

90003 INJ INTERNAL CAROTID ART 
9001 INJ INTERNL JUGULAR VEIN 

90081 INJ EXTERN JUGULAR VEIN 

90082 INJ MLT HEAD/NECK VESSEL 
90089 INJ HEAD/NECK VESSEL NEC 

9009 INJ HEAD/NECK VESSEL NOS 

9010 INJURY HORACIC AORTA 

9011 INJ INNOMIN/SUBCLAV ART 

9012 INJ SUPERIOR VENA CAVA 



64 



Table 2.8— Continued 

ICD-9-CM diagnosis codes which represent substantial complications or comorbidities when present as 

secondary diagnoses 



9013 INJ INNOMIN/SUBCLAV VEIN 

90141 INJURY PULMONARY ARTERY 

90142 INJURY PULMONARY VEIN 
90183 INJ MULT THORACIC VESSEL 
9020 INJURY ABDOMINAL AORTA 

90210 INJ INFER VENA CAVA NOS 

90211 INJURY HEPATIC VEINS 

90219 INJ INFER VENA CAVA NEC 

90220 INJ CELIAC/MESEN ART NOS 

90222 INJURY HEPATIC ARTERY 

90223 INJURY SPLENIC ARTERY 

90224 INJURY CELIAC AXIS NEC 

90225 INJ SUPER MESENTERIC ART 

90226 INJ BRNCH SUP MESENT ART 

90227 INJ INFER MESENTERIC ART 
90229 INJ MESENTERIC VESS NEC 

90231 INJ SUPERIOR MESENT VEIN 

90232 INJ INFERIOR MESENT VEIN 

90233 INJURY PORTAL VEIN 

90234 INJURY SPLENIC VEIN 

90239 INJ PORT/SPLEN VESS NEC 

90240 INJURY RENAL VESSEL NOS 

90241 INJURY RENAL ARTERY 

90242 INJURY RENAL VEIN 

90249 INJURY RENAL VESSEL NEC 

90250 INJURY ILIAC VESSEL NOS 

90251 INJ HYPOGASTRIC ARTERY 

90252 INJURY HYPOGASTRIC VEIN 

90253 INJURY ILIAC ARTERY 

90254 INJURY ILIAC VEIN 
90259 INJURY ILIAC VESSEL NEC 
90287 INJ MULT ABD/PELV VESSEL 
9040 INJ COMMON FEMORAL ARTER 
925 CRUSH INJ FACE/SCALP/NCK 
9290 CRUSH INJ MULT SITE NEC 

95200 C1-C4 SPIN CORD INJ NOS 

95201 COMPLETE LES C0RD/C1-C4 

95202 ANTERIOR CORD SYND/C1-C4 

95203 CENTRAL CORD SYND/C1-C4 

95204 C1-C4 SPIN CORD INJ NEC 

95205 C5-C7 SPIN CORD INJ NOS 

95206 COMPLETE LES CORD/C5-C7 

95207 ANTERIOR CORD SYND/C5-C7 

95208 CENTRAL CORD SYND/C5-C7 

95209 C5-C7 SPIN CORD INJ NEC 

95210 T1-T6 SPIN CORD INJ NOS 

95211 COMPLETE LES CORD/T1-T6 

95212 ANTERIOR CORD SYND/T1-T6 

95213 CENTRAL CORD SYND/T1-T6 

95214 T1-T6 SPIN CORD INJ NEC 

95215 T7-T12 SPIN CORD INJ NOS 

95216 COMPLETE LES CORD/T7-T12 

95217 ANTERIOR CORD SYN/T7-T12 

95218 CENTRAL CORD SYN/T7-T12 



95219 T7-T12 SPIN CORD INJ NEC 

9522 LUMBAR SPINAL CORD INJUR 

9523 SACRAL SPINAL CORD INJUR 

9524 CAUDA EQUINA INJURY 

9528 SPIN CORD INJ-MULT SITE 

9529 SPINAL CORD INJURY NOS 

9530 CERVICAL ROOT INJURY 

9531 DORSAL ROOT INJURY 

9532 LUMBAR ROOT INJURY 

9533 SACRAL ROOT INJURY 

9534 BRACHIAL PLEXUS INJURY 

9535 LUMBOSACRAL PLEX INJURY 

9538 MULT NERVE ROOT/PLEX INJ 

9539 INJ NERVE ROOT/PLEX NOS 

9580 AIR EMBOLISM 

9581 FAT EMBOLISM 

9582 SECONDARY/RECUR HEMORR 

9583 POSTTRAUM WND INFEC NEC 

9584 TRAUMATIC SHOCK 

9585 TRAUMATIC ANURIA 

9587 TRAUM SUBCUTAN EMPHYSEMA 
9954 SHOCK DUE TO ANESTHESIA 

99600 MALFUNC CARD DEV/GRF NOS 

99601 MALFUNC CARDIAC PACEMAKE 

99602 MALFUNC PROSTH HRT VALVE 

99603 MALFUNC CORON BYPASS GRF 
99609 MALFUNC CARD DEV/GRF NEC 

9961 MALFUNC VASC DEVICE/GRAF 

9962 MALFUN NEURO DEVICE/GRAF 
99630 MALFUNC GU DEV/GRAFT NOS 
99639 MALFUNC GU DEV/GRAFT NEC 

9964 MALF INT ORTHPED DEV/GRF 

9965 MALFUNC DEVICE/GRAFT NEC 

9966 INFEC/ INFLAM-DEVIC /GRAFT 

9967 COMPLIC DEVICE/GRAFT NEC 

9968 COMPL TRANSPLANTED ORGAN 

99690 COMP REATTACH EXTREM NOS 

99691 COMPL REATTACHED FOREARM 

99692 COMPL REATTACHED HAND 

9969 3 COMPL REATTACHED FINGER 

99694 COMPL REATTACHED ARM NEC 

99695 COMPL REATTACHED FOOT 

99696 COMPL REATTACHED LEG NEC 
99699 COMPL REATTACH PART NEC 

9970 SURG COMPLICATION-CNS 

9971 SURG COMPL-HEART 

9972 SURG COMP-PERI VASC SYST 

9973 SURG COMPLIC-RESPIR SYST 

9974 SURG COMPLIC-GI TRACT 

9975 SURG COMPL-URINARY TRACT 
99762 INFECTION AMPUTAT STUMP 
99 79 SURG COMPL-BODY SYST NEC 

9980 POSTOPERATIVE SHOCK 

9981 HEMORR COMPLIC PROCEDURE 



65 



Table 2.8— Continued 

ICD-9-CM diagnosis codes which represent substantial complications or comorbidities when present as 

secondary diagnoses 



9982 ACCIDENTAL OP LACERATION 

9983 POSTOP WOUND DISRUPTION 

9984 FB LEFT DURING PROCEDURE 

9985 POSTOPERATIVE INFECTION 

9986 PERSIST POSTOP FISTULA 

9987 POSTOP FORGN SUBST REACT 

9988 SURGICAL COMPLICAT NEC 

9989 SURGICAL COMPLICAT NOS 

9991 AIR EMBOL COMP MED CARE 

9992 VASC COMP MED CARE NEC 

9993 INFEC COMPL MED CARE NEC 

9994 ANAPHYLACTIC SHOCK-SERUM 

9995 SERUM REACTION NEC 

9996 ABO INCOMPATIBILITY REAC 



9997 RH INCOMPATIBILITY REACT 

9998 TRANSFUSION REACTION NEC 
V238 SUPRV HIGH-RISK PREG NEC 
V239 SUPRV HIGH-RISK PREG NOS 
V420 KIDNEY TRANSPLANT STATUS 
V421 HEART TRANSPLANT STATUS 
V422 HEART VALVE TRANSPLANT 
V426 LUNG TRANSPLANT STATUS 
V427 LIVER TRANSPLANT STATUS 
V428 TRANSPLANT STATUS NEC 
V432 HEART REPLACEMENT NEC 
V451 RENAL DIALYSIS STATUS 
V461 DEPENDENCE ON RESPIRATOR 



66 



setting where the care is administered. An approach 
was developed and tested that is described in 
Appendix XII. It should be noted that this approach 
was never implemented because it was extremely 
costly to run and did not provide as must information 
as had been anticipated. 

The process of forming DRGs for an MDC began 
by providing all patient abstracts within the MDC for 
AUTOGRP analysis. The recommendation of 
AUTOGRP was evaluated from both a statistical and 
clinical perspective. The process of forming the 
DRGs was iterative in nature. As each patient's 
characteristic was included in the DRG definitions, 
the process would then be repeated with the 
remaining patients' characteristics until there were no 
longer any patient characteristics from the medical 
and statistical perspective that affected length of stay. 
The result for each MDC was a tree-like structure 
based on patient characteristics defining the DRGs. 

At any point during the definition of the DRGs 
there would often be several patient characteristics 
that appeared important for understanding the length 
of stay. The selection of the patient characteristics 
and the order used, was a complex task with many 
factors examined and weighed simultaneously. 
Statistically, the amount of variance reduction in 
length of stay was only one factor considered. It is an 
artifact of the variance reduction algorithms that 
many subgroups can be created when there are a 
large number of different values of the patient 
characteristic. For example, secondary diagnoses 
often had many different values and thus often 
produced significant variance reduction by forming 
many subgroups. However, such groups were often 
not clinically coherent and were therefore not used in 
the DRG definitions. 

The recommendations from AUTOGRP were often 
modified by clinical judgment. Thus, while the type 
of surgery performed might be important from both a 
clinical and a statistical perspective, the surgical 
grouping suggested by AUTOGRP would be altered 
by the physicians in order to obtain surgical 
groupings that were more clinically homogeneous. 

During the preliminary phase of the research, Yale 
project staff developed a series of guidelines to be 
used in the formation of the DRGs incorporating the 
structural components described in Section 1 . The 
following guidelines were adhered to with few 
exceptions: 

• Except for principal diagnosis, no significance will 
be attached to the ordering of the diagnostic and 
procedural information on the patient record. Thus, 
partitions may be based on data contained in any of 
the diagnosis and procedure fields. 

• Whenever possible, the initial partition of each 
MDC will be based on the presence or absence of a 
procedure performed in the operating room. 

• Whenever possible, the initial partition of the 
surgical patients will be based on clinically 
coherent groups of operating room procedures 
referred to as procedure categories. 



• Operating room procedure categories will be 
hierarchical based on intensity of resource 
consumption. A patient with multiple operating 
room procedures will be assigned to the surgical 
group based on his or her most resource intensive 
operating room procedure within this hierarchy. 
For example, a patient in MDC 13 (Diseases and 
disorders of the female reproductive system) with a 
hysterectomy and D & C will be assigned to the 
surgical group containing hysterectomies. 

• Whenever possible, all partitions based on operating 
room procedure and principal diagnosis should be 
completed before use of other variables such as age 
or substantial complications and/or comorbidity. 

• Whenever possible, the initial partition of the 
medical patients will be based on clinically coherent 
groups of principal diagnoses. 

• From a clinical perspective, partitions should be as 
coherent as possible. In other words patients in the 
same DRG can be expected to evoke a set of 
clinical responses which results in a similar pattern 
of resource use. 

• Patient classes that occur very infrequently should 
not be formed unless they require highly specialized 
resources or are treated in particular types of 
hospitals) for example, heart transplants, kidney 
transplants). 

• Within an MDC, partitions based on age should be 
consistent. If age is used in multiple places within 
DRG definitions for a particular MDC, then age 
groupings should be consistent, unless there is a 
clinical rationale to do otherwise. 

• Death may be used as a variable in the definition of 
DRGs. 

• System variables, such as payment source or 
discharge status to a nursing home, are not direct 
patient attributes and therefore, must not be used to 
define the DRGs. Such variables are characteristics 
of the health system in which care is rendered. 
Resource consumption may be affected by such 
variables but that effect is not related to the type of 
patient being treated. 

In research project the ability to replicate the work 
is important. Classifying patients into groups based on 
the combination of clinical judgment and statistical 
results is critical. Since the construction of DRGs 
relied on a specific set of physician judgments, the 
guidelines described earlier were developed to 
enhance replicability. Additionally, three teams 
comprised of physicians and researchers were selected 
to replicate the formation of DRGs for Major 
Diagnostic Category 04: Diseases and disorders of the 
respiratory system, using preestablished guidelines. 
The approach taken to measuring agreement among 
different systems of classification is a method 
developed by Klastorin and Watts (Klastorin, 1978). 
This measure assesses the extent to which two 
classification schemes "agree" in their partitioning of 
patient records. Section 4 describes the Klastorin 
methodology as well as the results obtained by the 
replication teams. 



67 



Section 3: Construction of 
diagnosis-related groups 

The purpose of this classification scheme is to 
describe patients who are expected to receive similar 
sets of services in an acute care hospital. As such, the 
DRGs do not represent clinical algorithms. Rather, 
they identify clusters or groups of patients that are 
similar in terms of the resources used as measured by 
patient days of care and/or patient care related to 
direct cost. Treatment modalities and services are 
generally prescribed on the basis of diagnosis. The use 
of diagnostic procedures are a function of the 
patient's known or suspected condition. The length of 
time a patient is hospitalized has been linked to 
diagnosis as well. The formation of DRGs 
presupposes that groups can be defined for the pattern 
of resource consumption that is similar for cases 
within each group. 

Major diagnostic categories 

The consumption of hospital resources is 
profoundly influenced by the organ system involved 
and the clincial specialty of the provider. Given this, 
the initial step in the construction of the DRGs was 
to condense the 10,171 ICD-9-CM diagnosis codes 
into 23 organ system-related diagnostic groups 
referred to as Major Diagnostic Categories (MDCs) 
as described in Table 3.1. The main disease 
classification for ICD-9-CM is made up of 10,171 
diagnosis codes, with two supplementary 
classifications referred to as V Codes and E Codes 
totaling 1,657. The V Code supplementary 
classification covers codes for factors influencing 
health status and contact with health services. For 
purposes of this study, the E Codes were excluded. 
These categories are mutually exclusive with the 
exception of Major Diagnostic Category 12, Diseases 
and Disorders of the Male Reproductive System and 
Major Diagnostic Category 13, Diseases and 
Disorders of the Female Reproductive System, that 
include common diagnosis codes that involve 
urogenital problems. For these diagnoses, assignment 
to MDC 12 or 13 was based on sex. The MDC 
definition was carried out independently by each 
physician on the Yale staff. Agreement in the 



assignment of diagnosis codes was reached using a 
modified Delphi technique (Liston, 1975). 

The MDC approach to grouping diagnoses differs 
from the ICD-9-CM classification system which is 
organized into 17 sections on the basis of both 
etiology and organ system (see Table 3.2). The 23 
Major Diagnostic Categories are grouped on the basis 
of organ system rather than etiology because clinical 
care is delivered generally in accord with the organ 
system affected, not etiology. 

Infectious diseases related to a particular organ 
system were assigned to the MDC associated with the 
organ system rather than the Systemic Infectious 
Disease: MDC 18. For example, food poisoning and 
shigella dysenteriae are in MDC 11, Diseases and 
Disorders of Digestive System while pulmonary 
tuberculosis is in MDC 04, Diseases and Disorders of 
the Respiratory System. Miliary tuberculosis, and 
septicemia which involve the entire body system, are 
included in the infectious disease MDC 18. An 
example of the assignment of infectious and parasitic 
diagnosis codes to the 23 MDCs is presented in Table 

3.3. All the MDCs were created in a similar way. 

An example of Major Diagnostic Category 11: 
Diseases and disorders of kidney and urinary 
tract 

Overview 

The application of guidelines used in the formation 
of DRGs can best be illustrated in the context of an 
example: the classification of patients in MDC 11, 
diseases and disorders of the kidney and urinary tract. 
This category contains patients with a principal 
diagnosis (No ICD-9-CM codes) contained in Table 

3.4. The formation of the DRGs from this Major 
Diagnostic Category is summarized in the tree 
diagrams in Figure 3.1 and 3.2. Keys to symbols used 
in the diagrams are shown in Table 4. 1 found in 
Appendix II. In accordance with DRG guidelines, the 
initial partition of MDC 1 1 was based on the presence 
or absence of a procedure performed in the operating 
room. Each ICD-9-CM procedure code is classified 
either as requiring the use of an operating room or 
not. (A detailed list of operating room procedures is 
in Section 2). 



69 



Table 3.1 

Listing of 23 Major Diagnostic Categories 



Major Diagnostic Category number Major Diagnostic Category English description 

01 Diseases and disorders of the nervous system. 

02 Diseases and disorders of the eye. 

03 Diseases and disorders of the ear, nose, and throat. 

04 Diseases and disorders of the respiratory system. 

05 Diseases and disorders of the circulatory system. 

06 Diseases and disorders of the digestive system. 

07 Diseases and disorders of the hepatobiliary system and pancreas. 

08 Diseases and disorders of the musculoskeletal system and connective tissue. 

09 Diseases and disorders of skin, subcutaneous tissue and breast. 

10 Endocrine, nutritional, and metabolic diseases and disorders. 

1 1 Diseases and disorders of the kidney and urinary tract. 

12 Diseases and disorders of the male reproductive system. 

13 Diseases and disorders of the female reproductive system. 

14 Pregnancy, childbirth, and the puerperium. 

15 Newborns and other neonates with conditions originating in the perinatal period. 

16 Diseases and disorders of the blood and blood-forming organs and immunological disorders. 

17 Myeloproliferative diseases and disorders and poorly differentiated neoplasms. 

18 Infectious and parasitic diseases [systemic or unspecified sites]. 

19 Mental diseases and disorders. 

20 Substance use and substance induced organic mental disorders. 

21 Injuries, poisonings, and toxic effects of drugs. 

22 Burns. 

23 Factors influencing health status and contacts with health services. 

Table 3.2 

Relationship between ICD-9-CM categorization and Major Diagnostic Categories 

Major Diagnostic Category ICD-9-CM category 

Infectious and parasitic diseases [systemic or unspecified sites] Infectious and parasitic diseases. 

Endocrine, nutritional, and metabolic diseases and disorders Endocrine, nutritional, and metabolic diseases and immunity disor- 

ders. 

Diseases and disorders of the blood and blood-forming organs and Diseases of the blood and blood-forming organs, 
immunological disorders. 

Myeloproliferative disorders and poorly differentiated neoplasms Neoplasms. 

Mental diseases and disorders Mental disorders. 

Diseases and disorders of the nervous system Diseases of the nervous system and sense organs. 

Diseases and disorders of the eye 

Diseases and disorders of the ear, nose, and throat 

Diseases and disorders of the circulatory system Diseases of the circulatory system. 

Diseases and disorders of the respiratory system Diseases of the respiratory system. 

Diseases and disorders of the digestive system Diseases of the digestive system. 

Diseases and disorders of the hepatobiliary system and pancreas 

Diseases and disorders of the kidney and urinary tract Diseases of the genitourinary system. 

Diseases and disorders of the male reproductive system 

Diseases and disorders of the female reproductive system 

Pregnancy, childbirth, and the puerperium Complications of pregnancy, childbirth, and the puerperium. 

Diseases of the skin, subcutaneous tissue, and breast Diseases of the skin and subcutaneous tissue. 

Diseases and disorders of the musculoskeletal system and connec- Diseases of the musculoskeletal system and connective tissue, 
tive tissue. 

Newborns and other neonates with conditions originating in the Certain conditions originating in the perinatal period, 
perinatal period. 

Injuries, poisonings, and toxic effects of drugs Injury and poisoning. 

Burns 

Factors influencing health status and other contacts with health Classification of factors influencing health status and (Supplemental 

services. Classification). 
Substance use and substance induced organ mental disorders Congenital anomalies. Symptoms, signs, and ill-defined conditions. 



70 



Table 3.3 

An example of infectious and parasitic diseases ICD-9-CM diagnosis codes assigned to each Major 

Diagnostic Category 



Major Diagnostic Category 



Examples of ICD-9-CM code assignment 



Diseases and disorders of the nervous system 

Diseases and disorders of eye 

Diseases and disorders of the ear, nose and throat 

Diseases and disorders of the respiratory system 

Diseases and disorders of the circulatory system 

Diseases and disorders of the digestive system 

Diseases and disorders of hepatobiliary system and pancreas 

Diseases and disorders of the musculoskeletal system and connec- 
tive tissue 

Diseases and disorders of the skin, subcutaneous tissue, and 
breast 

Endocrine, nutritional, and metabolic diseases and disorders 

Diseases and disorders of the kidney and urinary tract 

Diseases and disorders of the male reproductive system 

Diseases and disorders of the female reproductive system 

Pregnancy, childbirth, and the puerperium 

Newborns and other neonates with conditions originating in the 
perinatal 

Diseases and disorders of the blood and blood-forming organs and 

immunological disorders 
Myeloproliferative disorders and poorly differentiated malignancey, 

and other neoplasms 

Infectious and parasitic diseases (systemic or unspecified sites) 

Mental diseases and disorders 

Substance use and substance induced organic mental disorders 

Injuries, poisonings, and toxic effects of drugs 

Burns 

Selected factors influencing health status and other contacts with 
health services 

Urogenital 



00321— Salmonella Meningitis. 

05441— Herpes Simplex of eyelid. 

01561— Tuberculosis of mastoid. 

01180— Pulmonary Tuberculosis not elsewhere classified. 

09321— Syphilitic endocarditis Mitral Valve. 

0040— Shigella Dysenteriae. 

1 305— Toxoplasma Hepatitis. 

05679— Arthritis due to Rubella. 

0220— Cutaneous anthrax. 

01752— Tuberculosis of thyroid exam unknown (at present). 

03284— Diphtheritic Cystitis. 

13103— Trichomonal Prostatitis. 

09836— GC Endometritis, chronic. 

Not applicable. 

Not applicable. 

01724— Tuberculosis Peripheral Lymph Cult Dx. 

No ICD-9-CM infectious 

signed to this category. 
0388— Septicemia NEC. 
No ICD-9-CM infectious 

signed to this category. 
No ICD-9-CM infectious 

signed to this category. 
No ICD-9-CM infectious 

signed to this category. 
No ICD-9-CM infectious 

signed to this category. 
No ICD-9-CM infectious 

signed to this category. 
05419— Genital Herpes NEC. 



and 


parasitic 


disease 


codes 


were 


as- 


and 


parasitic 


disease 


codes 


were 


as- 


and 


parasitic 


disease 


codes 


were 


as- 


and 


parasitic 


disease 


codes 


were 


as- 


and 


parasitic 


disease 


codes 


were 


as- 


and 


parasitic 


disease 


codes 


were 


as- 



419-177 O - 



84 - 



- 6 



71 



Table 3.4 

Listing of the assignment of ICD-9-CM diagnosis codes with English descriptions to MDC 1 1 diseases 

and disorders of the kidney and urinary tract 



Diagnosis code Abbreviated CPHA English description 



V420 Kidney transplant status. 

V435 Bladder replacement nec. 

V536 Fitting urinary devices. 

V555 Atten to cystostomy. 

V556 Atten to urinostomy nec. 

V560 Admit for renal dialysis. 

V568 Aftercare-dialysis nec. 

V594 Kidney donor. 

01600 TB of kidney-unspec. 

01601 TB of kidney-no exam. 

01602 TB of kidney-exam unkn. 

01603 TB of kidney-micro DX. 

01604 TB of kidney-cult DX. 

01605 TB of kidney-histo DX. 

01606 TB of kidney-oth test. 

01610 TB of bladder-unspec. 

01611 TB of bladder-no exam. 

01612 TB of bladder-exam unkn. 

01613 TB of bladder-micro DX. 

01614 TB of bladder-cult DX. 

01615 TB of bladder-histo DX. 

01616 TB of bladder-oth test. 

01620 TB of ureter-unspec. 

01621 TB of ureter-no exam. 

01622 TB of ureter-exam unkn. 

01623 TB of ureter-micro DX. 

01624 TB of ureter-cult DX. 

01625 TB of ureter-histo DX. 

01626 TB of ureter-oth test. 

01630 TB urinary nec-unspec. 

01631 TB urinary nec-no exam. 

01632 TB urinary nec-exam unkn. 

01633 TB urinary nec-micro DX. 

01634 TB urinary nec-cult DX. 

01635 TB urinary nec-histo DX. 

01 636 TB urinary nec-oth test. 

01690 GU TB nos-unspec. 

01691 GU TB nos-no exam. 

01692 GU TB nos-exam unkn. 

01693 GU TB nos-micro DX. 

01694 GU TB nos-cult DX. 

01695 GU TB nos-histo DX. 

01696 GU TB nos-oth test. 

03284 Diphtheritic cystitis. 

0786 Hem nephrosnephritis. 

0954 Syphilis of kidney. 

09811 GC cystitis (acute). 

09830 CHR GC upper GU nos. 

09831 GC cystitis, chronic. 

1200 Schistosoma haematobium. 

1372 Late effect GU TB. 

1880 Mai neo bladder-trigone. 

1881 Mai neo bladder-dome. 

1882 Mai neo bladder-lateral. 

1883 Mai neo bladder-anterior. 

1884 Mai neo bladder-post. 

1885 Mai neo bladder neck. 

1886 Mai neo ureteric orifice. 

1887 Malig neo orachus. 

1888 Malig neo bladder nec. 

1889 Malig neo bladder nos. 

1890 Malig neopl kidney. 

1891 Malig neo renal pelvis. 

1892 Malign neopl ureter. 

1893 Malign neopl urethra. 

1894 Mai neo paraurethral. 

1898 Mai neo urinary nec. 

1899 Mai neo urinary nos. 

1980 Second malig neo kidney. 



72 



Diagnosis code Abbreviated CPHA English description 



1 981 Sec malig neo urin nec. 

2230 Benign neoplasm kidney. 

2231 Benign neo renal pelvis. 

2232 Benign neoplasm ureter. 

2233 Benign neoplasm bladder. 

22381 Benign neoplasm urethra. 

22389 Benign neo urinary nec. 

2239 Benign neo urinary nos. 

2337 Ca in situ bladder. 

2339 Ca in situ urinary nec. 

2367 Unc behav neo bladder. 

23690 Unc behav neu urinar nos. 

23691 Unc behav neo kidney. 

23699 Unc behav neo urinar nec. 

2394 Bladder neoplasm nos. 

2395 Other GU neoplasm nos. 

27410 Gouty nephropathy nos. 

27411 Uric acid nepnrolithias. 

27419 Gouty nephropathy nec. 

30650 Psychogenic gu dis nos. 

30653 Psychogenic dysuria. 

30659 Psychogenic gu dis nec. 

34461 Neurogenic bladder. 

4030 Mai hypertens renal dis. 

4031 Benign hypert renal dis. 

4039 Hypertens renal dis nos. 

4401 Renal artery atheroscler. 

4421 Renal artery aneurysm. 

4473 Renal artery hyperplasia. 

4533 Renal vein thrombosis. 

5800 Ac proliferat nephritis. 

5804 Ac rapd ly progr nephrit. 

58081 Ac nephritis in oth dis. 

58089 Acute nephritis nec. 

5809 Acute nephritis nos. 

5810 Nephrotic syn, prolifer. 

5811 Epimembranous nephritis. 

5812 Membranoprolif nephrosis. 

5813 Minimal change nephrosis. 

58181 Nephrotic syn in oth dis. 

58189 Nephrotic syndrome nec. 

5819 Nephrotic syndrome nos. 

5820 Chr proliferat nephritis. 

5821 Chr membranous nephritis. 

5822 Chr membranoprolif nephr. 

5824 Chr rapid progr nephrit. 

58281 Chr nephritis in oth dis. 

58289 Chronic nephritis nec. 

5829 Chronic nephritis nos. 

5830 Proliferat nephritis nos. 

5831 Membranous nephritis nos. 

5832 Membranoprolif nephr nos. 

5834 Rapidly prog nephrit nos. 

5836 Renal cort necrosis nos. 

5837 Nephr nos/medull necros. 

58381 Nephritis no in oth dis. 

58389 Nephritis nec. 

5839 Nephritis nos. 

5845 Lower nephron nephrosis. 

5846 Ac renal fail, cort necr. 

5847 Ac ren fail, midull necr. 

5848 Ac renal failure nec. 

5849 Acute renal failure nos. 

585 Chronic renal failure. 

586 Renal failure nos. 

587 Renal sclerosis nos. 

5880 Renal osteodystrophy. 

5881 Nephrogen diabetes insip. 

5888 Impaired renal funct nec. 



Table 3.4— Continued 

Listing of the assignment of ICD-9-CM diagnosis codes with English descriptions to MDC 1 1 diseases 

and disorders of the kidney and urinary tract 



Diagnosis code Abbreviated CPHA English description 



5889 Impaired renal funt nos. 

5890 -Unilateral small kidney. 

5891 Bilateral small kidneys. 

5899 Small kidney nos. 

59000 Chr pyelonephritis nos. 

59001 Chr pyeloneph w med necr. 

59010 Ac pyelonephritis nos. 

59011 Ac pyelonephr w med necr. 

5902 Renal/perirenal abscess. 

5903 Pyeloureteritis cystica. 

59080 Pyelonephritis nos. 

59081 Pyelonephrit in oth dis. 

5909 Infection of kidney nos. 

591 Hydronephrosis. 

5920 Calculus of kidney. 

5921 Calculus of ureter. 

5929 Urinary calculus nos. 

5930 Nephroptosis. 

5931 Hypertrophy of kidney. 

5932 Cyst of kidney, acquired. 

5933 Stricture of ureter. 

5934 Ureteric obstruction nec. 

5935 Hydroureter. 

5936 Postural proteinuria. 

5937 Vesicoureteral reflux. 

58381 Renal vascular disorder. 

59362 Ureteral fistula. 

59389 Renal ureteral dis nec. 

5939 Renal ureteral dis nos. 

5940 Blad diverticulum calcul. 

5941 Bladder calculus nec. 

5942 Urethral calculus. 

5948 Lower urin calcul nec. 

5949 Lower urin calcul nos. 

5950 Acute cystitis. 

5951 Chr interstit cystitis. 

5952 Chronic cystitis nec. 

5953 Trigonitis. 

5954 Cystitis in oth dis. 

59581 Cystitis cystica. 

59582 Irradiation cystitis. 

59589 Cystitis nec. 

5959 Cystitis nos. 

5960 Bladder nec obstruction. 

5961 Intestinovesical fistula. 

5962 Vesical fistula nec. 

5963 Diverticulum of bladder. 

5964 Atony of bladder. 

5965 Bladder dysfunction nec. 

5966 Bladder rupt, nontraum. 

5967 Bladder wall hemorrhage. 

5968 Bladder disorder nec. 

5969 Bladder disorder nos. 

5970 Urethral abscess. 

59780 Urethritis nos. 

59781 Urethral syndrome nos. 

59789 Urethritis nec. 

59800 Urethr strict: infect nos. 

59801 Ureth strict: oth infect. 

5981 Traum urethral structure. 

5982 Postop urethral strictur. 

5988 Urethral stricture nec. 



Diagnosis code Abbreviated CPHA English description 



5989 Urethral stricture nos. 

5990 Urin tract infection nos. 

5991 Urethral fistula. 

5992 Urethral diverticulum. 

5993 Urethral carbuncle. 

5994 Urethral false passage. 

5995 Prolapse urethral mucosa. 

5996 Urinary obstruction nos. 

5997 Hematuria. 

5998 Urinary tract dis nec. 

5999 Urinary tract dis nos. 

7530 Renal agenesis. 

7531 Cystic kidney disease. 

7532 Congen ureteral obstruct. 

7533 Kidney anomaly nec. 

7534 Ureteral anomaly nec. 

7535 Bladder exstrophy. 

7536 Congen urethral stenosis. 

7537 Anomalies of urachus. 

7538 Cystourethral anom nec. 

7539 Urinary anomaly nos. 

7880 Renal colic. 

7881 Dysuria. 

7882 Retention of urine. 

7883 Incontinence of urine. 

7884 Freq urination/polyuria. 

7885 Oliguria. 

7886 Urination abnorm. 

7887 Urethral discharge. 

7888 Extravasation of urine. 

7889 Urinary sys symptom nec. 

7910..: Proteinuria. 

7911 Chyluria. 

7912 Hemoglobinuria. 

7917 Oth cells/casts in urine. 

7919 Abn urine findings nec. 

7935 Abn findings-gu organs. 

7944 Abn kidney funct study. 

7949 Abn function study nec. 

86600 Kidney injury nos — closed. 

86601 Kidney hematoma— closed. 

86602 Kidney Laceration— closed. 

86603 Kidney Disruption — open. 

86610 Kidney injury nos— open. 

8661 1 Kidney hematoma— open. 

86612 Kidney laceration— open. 

86613 Kidney disruption — open. 

8670 Bladder/urethra inj— clos. 

8671 Bladder/urethra inj— open. 

8672 Ureter injury— closed. 

8673 Ureter injury— open. 

86804 Retroperitoneum inj — cl. 

86814 Retroperitoneum inj— open. 

9390 Fb bladder urethra. 

9399 Foreign bdy gu tract nos. 

9585 Traumatic anuria. 

99630 Malfunc gu dev/graft nos. 

99631 Malfunc urethral cath. 

99639 Malfunc gu dev/graft nec. 

9975 Surg compl-urinary tract. 



73 



U) 

c 



a, 

ra 
u 

a> 



u 
n 



■o 

c 
co 

5* 

CD 

c 

TJ 

!5 

CD 
J= 

™ o 

■II 

LL w 
O 

CO 



■o 
c 

CO 

(J) 

CO 
CO 
CD 
CO 



o 
cn 

CD 



siuoadmXt; 



pu? suSis 



3uo;s 



CO 

o 



CO 



o 

CO 



ujSB|doaN 




Q. 

E 

o 
o 



C 

CO 

2> 

■2 
o 
E 
o 

O 

II 

o 
o 



74 



sainpasojd MO 



lejmajnsupj 



pue jajsjfl Xaupi^^ 




CL 

E 
o 
O 



c 
CO 



o 
E 



8 



75 



The group of medical patients includes both those 
without operating room procedures, and/or those 
identified by a non-operating room procedure code(s). 
The surgical group contains patients who had an 
operating room procedure performed. Several 
examples of operating room procedure(s) as found in 
MDC 11 are given in Table 3.5. 

Table 3.5 

Examples of operating room procedures MDC 11: 
Diseases and disorders of the kidney and urinary 
tract 



Procedure code Abbreviated CPHA English description 



5551 Nephroureterectomy. 

602 Transurethral Prostatectomy. 

604 Retropubic Prostatectomy. 

5786 Bladder Exstrophy Repair. 

5569 Kidney Transplant Not Elsewhere Classi- 

fied. 

5685 Ureteropexy. 



All surgical patients in MDC 1 1 with an operating 
room procedure are divided into seven subcategories, 
based on the specific operating room procedures 
performed. Broadly defined, these surgical subgroups 
are: kidney transplant, kidney, ureter, and major 
bladder, prostatectomy, other bladder, transurethral, 
urethra, and other. Five of the seven operating-room 
procedure categories are further partitioned on the 
basis of one or two of the following patient attributes: 
age, principal diagnosis of malignancy, 70 years of age 
or over, and the presence of absence of a substantial 
comorbidity or complication. 

For MDC 11, the medical group is also divided 
into seven categories based on principal diagnosis: 
renal failure, neoplasm, infection, stone, signs and 
symptoms, urethral stricture, and other. Each of these 
groups is further subdivided using at least one 
variable. Among the variables used are principal 
diagnosis of dialysis, age, 70 years of age and over, 
and the presence or absence of a substantial 
complication or comorbidity. 

Through the classification process, 32 terminal 
groups or DRGs were formed for MDC 11, diseases 
and disorders of the kidney and urinary tract. (Table 
3.6 contains abbreviated descriptions of DRGs 302 
through 333. A complete list of DRG definitions is 
summarized in Table 4.3.) 



Table 3.6 

Descriptive summary of DRGs 302-333, Major 
Diagnostic Category 11: Diseases and disorders 
of the kidney and urinary tract 



MDC n umtLr English description 



302 Kidney transplant. 

303 Kidney, ureter and major bladder proce- 

dure for neoplasm. 

304 Kidney, ureter and maj. bldr. proc. for non- 

malig age > =70 and/or C.C. 

305 Kidney, ureter and maj. bldr. proc. for non- 

malig age <70 w/o C.C. 

306 Prostatectomy age > =70 and/or C.C. 

307 Prostatectomy age < 70 w/o C.C. 

308 Minor bladder procedures age >=70 

and/or C.C. 

309 Minor bladder procedures age <70 w/o 

C.C. 

310 Transurethral procedures age >=70 and/ 

or C.C. 

311 Transurethral procedures age <70 w/o 

C.C. 

312 Urethral procedures, age >=70 and/or 

C.C. 

313 Urethral procedures, age 18-69 w/o C.C. 

314 Urethral procedures, age 0-17. 

315 Other kidney and urinary tract O.R. proce- 

dures. 

316 Renal failure w/o dialysis. 

317 Renal failure with dialysis. 

318 Kidney and urinary tract neoplasms age 

>=70 and/or C.C. 

319 Kidney and urinary tract neoplasms age 

<70 w/o C.C. 

320 Kidney and urinary tract infections age 

> = 70 and/or C.C. 

321 Kidney and urinary tract infections age 18- 

69 w/o C.C. 

322 Kidney and urinary tract infections age 0- 

7. 

323 Urinary stones age >=70 and/or C.C. 

324 Urinary stones age <70 w/o C.C. 

325 Kidney and urinary tract signs & symptoms 

age > =70 and/or C.C. 

326 Kidney and urinary tract signs & symptoms 

age 18-69 w/o C.C. 

327 Kidney and urinary tract signs & symptoms 

age 0-1 7. 

328 Urethral stricture age >=70 and/or C.C. 

329 Urethral stricture age 18-69 w/o C.C. 

330 Urethral stricture age 0-17. 

331 Other kidney and urinary tract diagnoses 

age > =70 and/or C.C. 

332 Other kidney and urinary tract diagnoses 

age 1 8-69, w/o C.C. 

333 Other kidney and urinary tract diagnoses 

age 0-17. 



76 



Figure 3.3 

Length-of-stay distributions for all patients in MDC-11: Diseases and disorders of the kidney and 

urinary tract 

Value OBS Percent Cum percent Mean 6.46 JSSSSm piSm&S 



1.00 


1,170 


12.52 


12.52 


2.00 


1,502 


16.08 


28.60 


3.00 


1,129 


12.09 


40.69 


4.00 


947 


10.14 


50.82 


5.00 


742 


7.94 


58.77 


6.00 


584 


6.25 


65.02 


7.00 


482 


5.16 


70.18 


8.00 


422 


4.52 


74.69 


9.00 


406 


4.35 


79.04 


10.00 


295 


3.16 


82.20 


11.00 


232 


2.48 


84.68 


12.00 


209 


2.24 


86.92 


13.00 


176 


1.88 


88.80 


14.00 


166 


1.78 


90.58 


15.00 


115 


1.23 


91.81 


16.00 


87 


.93 


92.74 


17.00 


102 


1.09 


93.83 


18.00 


71 


.76 


94.59 


19.00 


64 


.69 


95.28 


20.00 


49 


.52 


95.80 


21.00 


56 


.60 


96.40 


22.00 


46 


.49 


96.90 


23.00 


41 


.44 


97.33 


24.00 


25 


.27 


97.60 


25.00 


22 


.24 


97.84 


26.00 


24 


.26 


98.09 


27.00 


29 


.31 


98.40 


28.00 


17 


.18 


98.59 


29.00 


16 


.17 


98.76 


30.00 


17 


.18 


98.94 


31.00 


23 


.25 


99.19 


32.00 


17 


.18 


99.37 


33.00 


15 


.16 


99.53 


34.00 


10 


.11 


99.64 


35.00 


11 


.12 


99.75 


36.00 


14 


.15 


99.90 


37.00 


9 


.10 


100.00 



Figure 3.3 contains a descriptive statistical summary 
and LOS histogram for the CPHA LOS data base 
used to construct DRGs in MDC 1 1 . This category is 
comprised of 9,342 observations, with a mean LOS of 
6.46 and standard deviation of 6.08. The variables 
used in partitioning were operating room procedures, 
principal diagnosis, age, and 70 years of age and over, 
or the presence of a substantial complication or 
comorbidity. 

Using the above definitions, the groups were tested 
by comparing them to the New Jersey State 
Department of Health cost data set. The group 
statistics were examined to determine if the splits 
based on cost confirmed those groups developed 



found using CPHA LOS data. In general there was a 
consistent agreement found between the data bases. In 
this case, no additional DRGs were recommended for 
the surgical and medical partitions as a result of this 
comparison. 

The findings indicated that specific operating room 
procedures, principal diagnosis, age, presence of 
substantial complications, and comorbidities were 
important variables in predicting LOS and cost. Each 
DRG formed is clinically coherent and the DRG 
definitions can be used to communicate effectively 
with physicians and other health care professionals. 
Additionally, each DRG is distinct with respect to 
both LOS and cost. 



77 



The actual process of constructing these DRGs 
from the Major Diagnostic Category 1 1 is 
summarized in the following steps: 

Step 1 

Records with obvious coding errors or missing data 
were excluded from the data set since their data could 
be misleading. In addition, all observations which has 
a LOS which exceeded three standard deviations 
above the mean were removed. As a result, 121 
records (outliers) were deleted. This reduced the size 
of MDC 1 1 from 9,463 to 9,342. In the 383 DRG 
version, deaths were excluded from further analysis; 
in this scheme they were included. 

Step 2 

In accordance with the guidelines described in 
Section 2, the initial subdivision of this category was 
on the basis of the presence or absence of an 
operating room procedure. This resulted in the 
formation of two groups comprised of surgical and 
medical patients, respectively. 

Step 3 

The automated interaction detector (AID) 
algorithm was applied to define operating room 
procedure categories for the surgical patients, and 
diagnostic groups for medical patients. The objective 
of the AID approach is to analyze the 
interrelationships of the variables in the data base and 
to determine which one(s) is/are related to the 
dependent variable. 

Surgical categories: The AID statistical algorithm 
was invoked to determine how to further subdivide 
surgical cases. Initially, an abbreviated list of 
operating room procedures for patients with disorders 



of Kidney and Urinary Tract was grouped using the 
"classify" command in AUTOGRP. This approach 
attempts to maximize the percentage of variance that 
is explained by subdividing the cases into categories. 
The number of groups formed by the algorithm and 
the corresponding percent reduction in unexplained 
variation for patients undergoing operating room 
procedures is described in Table 3.7. The algorithm 
suggested that five groups should be formed with 
length of stay functioning as the dependent variable. 
This table presents the different surgical procedures 
contained in each group, the corresponding number of 
observation (SIZE), and the mean length of stay 
(MEAN). A closer examination was made of the 
characteristics of the AID results. Combining 
statistical results and clinical judgment produced a 
definitional change in the original five groups 
suggested by the AID method shown in Table 3.8. 
The data suggested possibly creating six groups; a 3- 
day short-stay group of procedures on the urethra 
(U); a transurethral (T) group staying 5 days; an 8-day 
short-stay bladder group (OB); a group consisting of 
procedures on the kidney, ureter, or major procedures 
on the bladder (KU&B) staying approximately 12 
days; a small distinctive group of kidney transplant 
(KT) patients staying 23 days, and an "other" group. 
A separate kidney transplant group was justified on 
clinical grounds even though the CPHA data base 
contained only a small number of such rare cases. 

Often, in exploring independent variables selected 
to define potential subgroups, we would alter groups 
initially defined. For instance, groups may be 
combined, or a smaller subset may be spun off from a 
larger group. For example, a Prostatectomy Group, 
separated from the other operating room procedure 
category, resulted in the creation of seven surgical 
categories. 



78 



! 



Table 3.7 

Preliminary operating room procedure listing used in the conceptualization of initial operating room 

procedure categories 

94 CELLS TSS- 1.449E+05 OBSERVATIONS- 2939 
S GROUPS TBS- 87909.00 PCT.REDUCT- 39. 3X 

*** SIZE- 456 MEAN- 3.43 80- 3.56 8S0- 5757.77 «** 

SIZE MEAN INDEP WAR 

U 5 117 2.49 581 URETHRAL HEATOTOMY 

U 7 31 3.35 5847 URETHRAL MEATOPLASTY 

U 8 285 3.84 585 URETH STRICTURE RELEASE 

OB 9 13 4.23 5791 BLADDER SPHINCTEROTOMY 





*** 


c t 7F= 1200 


MEAN- 


5.68 








SIZE 


MEAN 


INDEP 


WAR 


KU&B 


12 


22 


5 . 05 


561 


URETERAL MEATOTOMY 


T 


13 


293 


5.29 


560 


TU REMOV URETER OBSTRUCT 


T 


14 


77 


5.35 


5733 


TRANSURETH BLADD BIOPSY 


T 




529 


5.41 


5749 


tii hpqtpi ir m Ann i pq wrr 

IU I'CO I r\Uw ruHL'U 1 LtO PILL 


OB 


18 


98 


6.24 


5734 


BLADDER BIOPSY NEC 


U 


24 


22 


7 ♦ 77 


580 


URETHROTOMY 


UB 


£./ 


i p 


w • A. O 


J/ J7 






%%% 


SIZE= 900 


MEAN= 


11.12 


SD- 6.30 SS0- 35657.31 






SIZE 


MEAN 


INDEP 


VAR 




39 


13 


9.38 


3942 


REVIS REN DIALYSIS SHUNT 




40 


76 


9.66 


3927 


DIALYSIS ARTERI0VEN0ST0M 


U 


42 


25 


10.12 


5849 


URETHRAL REPAIR NEC 


OB 


43 


22 


10.41 


595 


RETROPUBIC URETH SUSPENS 


KU&B 


44 


46 


10.70 


5674 


URETER0NE0CYST0ST0MY 


KU&3 


45 


265 


10.86 


562 


URETEROTOMY 


KU&B 


48 


119 


11.40 


5511 


PYEL0T0MY 


49 


170 


11.54 


602 


TRANSURETHRAL PR0STATECT 




52 


35 


12.17 


3993 


INSERT VES-T0-VES CANNUL 


KU&S 


53 


21 


12.43 


5641 


PARTIAL URETERECTOMY 


OB 


54 


30 


12.43 


5721 


FORMATION OF CYSTOSTOMY 


KU&B 


56 


29 


12.79 


5587 


CORRECT URETEROPELV JUNC 


KU&B 


58 


14 


13.00 


554 


PARTIAL NEPHRECTOMY 





*** 


SIZE- 338 


MEAN= 


15.49 


SD- 7.38 SSQ= 18360.00 






SIZE 


MEAN 


INDEP 


VAR 




61 


8 


14.00 


5411 


EXPLORATORY LAPAROTOMY 


KU&B 


64 


49 


14.27 


5501 


NEPHROTOMY 


OB 


65 


25 


14.32 


576 


PARTIAL CYSTECTOMY 


KU&B 


68 


146 


15.29 


5551 


NEPHROURETERECTOMY 


OB 


69 


11 


15.36 


5781 


SUTURE BLADDER LACERAT 




70 


5 


15.40 


604 


RETROPUBIC PROSTATECTOMY 


KU&B 


72 


25 


15.52 


5524 


RENAL BIOPSY NEC 


KU&B 


74 


9 


16.33 


5502 


NEPHROSTOMY 


KU&B 


78 


14 


17.29 


5651 


FORM CUTAN ILEOURETEROST 




81 


13 


18.62 


603 


SUPRAPUBIC PROSTATECTOMY 


KU&B 


83 


9 


19.33 


5771 


RADICAL CYSTECTOMY 





*** 


SIZE- 45 


MEAN- 


25.53 


SD- 8.22 SSQ- 2975.81 






SIZE 


MEAN 


INDEP 


VAR 


KU&B 


85 


15 


22.80 


5779 


TOTAL CYSTECTOMY NEC 




86 


5 


23.00 


4011 


LYMPHATIC STRUCT BIOPSY 


KU&B 


87 


1 


24.00 


5591 


RENAL DECAPSULATION 


KT 


88 


11 


24.45 


5569 


KIDNEY TRANSPLANT NEC 




89 


3 


25.67 


5012 


LIVER BIOPSY NEC 




90 


2 


30.00 


605 


RADICAL PROSTATECTOMY 




91 


1 


32.00 


5412 


REOPEN RECENT LAP SITE 


OB 


92 


4 


32.25 


5783 


ENTEROVESICO FIST REPAIR 


KU&B 


93 


2 


32.50 


5901 


URETEROLYS FOR FIBROSIS 




94 


1 


36.00 


3943 


REMOV REN DIALYSIS SHUNT 



Key: 

KT ■ Kidney Transplant OB ■ Other Bladder T ■ Transurethral 

KU&B * Kidney Ureter and Major Bladder U * Urethra 



79 



Table 3.8 

Step 1 of preliminary assignment to operating 
room procedure categories 



Ureteral meatotomy 

Loc destr renal les NEC 

Ureterotomy 

Pyclotomy 

Partial ureterectomy 

Correct ureteropelv junc 

Partial neprectomy 

Nephrotomy 

Renal biopsy NEC 

Nephrostomy 

Form cutan ileoureterost 

Radical cystectomy 

Total cystectomy NEC 

Renal decapulation 

Ureterolys for fibrosis 

Ureteroneocystostomy 

Nephroureterectomy 

Urethral meatotomy 

Urethral meatoplasty 

Ureth stricture release 

Urethrotomy 

Urethral repair NEC 

Urethral meatoplasty 

TU removal ureter obstruct. 
TU descruc bladd les NEC . 
Transureth bladd biopsy 



Kidney, ureter, and major 
bladder average LOS is 
approximately 1 2 days. 



Kidney transplant . 



Bladder biopsy NEC 

Bladder spincterotomy 

Bladder les destruction NEC .. 

Retropubic ureth suspems 

Patial cystectomy 

Enterovesico fist repair 

Formation of cystostomy 

Suture bladder lacerat 



Urethra average LOS is ap- 
proximately 3 days. 



Transurethral average LOS 
is approximately 5 days. 

Kidney transplant average 
LOS is approximately 24 
days. 



Other bladder average LOS 
is approximately 8 days. 



Other 



Medical categories: The steps used in the analysis of 
the surgical categories was repeated for the medical 
categories. First, an abbreviated list of principal 
diagnoses for medical patients with disorders of 
kidney and urinary tract was reviewed (shown in 
Table 3.9). For this MDC, the LOS for the principal 
diagnoses ranged from 1 day to 17 days. The 
statistical algorithm (AID) was applied to all medical 
patients with disorders of the kidney and urinary 
tract. The statistics suggested three groups should be 
formed. The first group of patients were a short-stay 
stone group. Additionally, this group contained 
patients with infections, signs and symptoms. The 
second group had a slightly different mix of cases. It 
contained cases with a principal diagnoses of 
infections, signs and symptoms, renal failure and 
neoplasms. The third group consisted of a mixture of 
principal diagnoses, including renal failure, neoplasms, 
and signs and symptoms. Based on clinical judgement, 
along with statistical results described above, major 
subsets within all three groups were identified as 
stone, infection, renal failure, signs and symptoms, 
neoplasms and other (shown in Table 3.10). The 
"other" group consisted of principal diagnoses which 
occurred relatively infrequently. There were 
insufficient observations to separate them into distinct 
groups. It should be noted that a seventh category 
was isolated from one of the six categories resulting in 
the formation of a seventh medical category referred 
to as urethral stricture. 

Step 4 

All possible principal diagnoses and operating room 
procedures relating to diseases and disorders of the 
kidney do not appear in the sample. It was therefore 
necessary to refer to the ICD-9-CM Volume II, 
Diseases: Tabular List to develop a comprehensive list 
for each of the diagnostic categories and ICD-9-CM 
Volume III, Procedures: Tabular List and Alphabetic 
Index for each of the surgical categories. For 
purposes of illustration consider the infection category 
in MDC 11 (summarized in Table 3.11). Only nine 
diagnoses relating to infections of the urinary system 
occurred with any significant frequency within the 
data base, the final group definition was comprised of 
66 diagnoses. Therefore, when we refer to DRGs 
320-321 all infections related to the urinary system. 
Again, the principal diagnosis listing from the sample 
was used primarily to identify any additional 
underlying concepts. 



80 



Table 3.9 

Preliminary principal diagnosis listing used in the conceptualization of initial categories 

Principal Diagnoses 

154 CELLS TSS= 1.647E+05 OBSERVATIONS^ 6204 
3 GROUPS TSS= 1.416E+05 PCT.REBUCT= 14% 





* * * 


Slit 1 Ol J7 


ntnn = 


T 71 

<9 . 1 1 


eric t ac\ ccn— ixiiA 






C T 7C 


MP Akl 
ntHfi 


Turirp 
1 ni>cr 


MAP 
Vnr\ 




i 


JO 


1 * 11 


VSOD 


AFTFRTARF— HT Al YCT^ NFP 




1 7 




d, ♦ y*c 


/ODj 


TurnwTTucwrr nc 1 id tup 
XNUUrt 1 1 flbfiLL Ur UKlnt 


c 


d- o 


Oi 


w ♦ UO 


37*7 


HPT NARY rAI Pill HQ MflQ 


c 
o 


<c / 




w ♦ 1 O 


59?1 


r Ai riii MQ OF IIRFTFR 


c 
3 


£ D 


eg 


O • £ X 


□ 7 J t«t. 


IIPFTWPAI TAI mi HQ 


r 




1 Pi 


«9 • *t O 


/OOV 


rfwai rni TP 

nCnnL tut il 


I 


37 


101 


3.53 


59780 


URETHRITIS N0S 




39 


296 


3.86 


5989 


URETHRAL STRICTURE N0S 


s 


40 


367 


3.98 


5920 


CALCULUS OF KIDNEY 


I 


41 


65 


4.00 


5953 


TRIG0NITIS 


s&s 


53 


332 


4.16 


5997 


HEMATURIA 




54 


43 


4.16 


5934 


URETERIC OBSTRUCTION NEC 




58 


32 


4.34 


5960 


BLADDER NECK OBSTRUCTION 




73 


53 


5.02 


86601 


KIDNEY HEMAT0MA-CL0SED 


I 


75 


86 


5.17 


5950 


ACUTE CYSTITIS 




76 


58 


5.24 


5932 


CYST OF KIDNEY* ACQUIRED 





*** 


SIZE= 2714 


MEAN= 


6.69 


SD= 5.52 SSQ= 82655 






SIZE 


MEAN 


INDEP 


VAR 


I 


83 


237 


5.64 


5959 


CYSTITIS N0S 


I 


84 


274 


5.68 


59080 


PYELONEPHRITIS N0S 


I 


91 


44 


6.16 


59000 


CHR PYELONEPHRITIS N0S 


S&S 


93 


137 


6.23 


7882 


RETENTION OF URINE 




94 


58 


6.29 


34461 


NEUROGENIC BLADDER 


I 


96 


278 


6.50 


59010 


AC PYELONEPHRITIS N0S 


I 


99 


1052 


6.75 


5990 


URIN TRACT INFECTION N0S 


I 


101 


30 


6.87 


5952 


CHRONIC CYSTITIS NEC 




103 


54 


6.96 


5939 


RENAL URETERAL DIS N0S 


S&S 


110 


28 


7.54 


5819 


NEPHROTIC SYNDROME N0S 


RF 


117 


205 


8.13 


585 


CHRONIC RENAL FAILURE 


N 


119 


73 


8.23 


1889 


MALIG NE0 BLADDER N0S 




121 


58 


8.40 


4039 


HYPERTENS RENAL DIS N0S 



.12 *** 





*** 


SIZE= 331 


MEAN = 


10.77 






SIZE 


MEAN 


INDEP 


N 


130 


62 


9.08 


1890 




131 


5 


9.40 


5888 




132 


8 


9.63 


58389 


RF 


133 


8 


9.75 


5809 




135 


7 


10.00 


587 




137 


5 


10.00 


1981 




138 


106 


10.06 


586 




139 


9 


10.22 


5964 


S&S 


140 


14 


10.64 


7919 




141 


9 


10.67 


4031 




144 


4 


11.75 


58181 




147 


24 


12.00 


5829 


RF 


148 


40 


13.45 


5849 




149 


5 


13.80 


1892 




151 


4 


15.25 


4030 




154 


4 


17.00 


4421 



SD= 8.26 SSQ= 22503.77 *** 

VAR 

MALIG NE0PL KIDNEY 
IMPAIRED RENAL FUNCT NEC 
NEPHRITIS NEC 
ACUTE NEPHRITIS N0S 
RENAL SCLEROSIS N0S 
SEC MALIG NE0 URIN NEC 
RENAL FAILURE N0S 
ATONY OF BLADDER 
ABN URINE FINDINGS NEC 
BENIGN HYPERT RENAL DIS 
NEPHROTIC SYN IN OTH DIS 
CHRONIC NEPHRITIS NOS 
ACUTE RENAL FAILURE NOS 
MALIGN NEOPL URETER 
MAL HYPERTENS RENAL DIS 
RENAL ARTERY ANEURYSM 



Key: 

I * Infection RF « Renal Failure S ■ Stone 

S&S * Signs and Symptoms N ■ Neoplasm 



Table 3.10 

Step 1 and 2 of preliminary assignment of 
principal disganoses 



Step 1: 

Calculus of ureter 

Urethral calculus 

Urinary calculus NOS 

Renal colic 

Calclus of kidney 

Urethritis NOS 

Trigonitis 

Acute cystitis 

Cystitis NOS 

Pyelonephritis NOS 

CHR pyelonephritis NOS . 
AC pyelonephritis NOS .... 
Urin tract infection NOS.., 

Chronic cystitis NEC 

Chronic renal 

Failure 

Renal failure NOS 

Acute renal failure 



Step 2: 

Malignant neo bladder NOS... I 

Malignant neo kidney J 

Incontinence of urine 

Hematuria 

Retention of urine 

Neprotic syndrome NOS 

Abn. urine findings NEC 



Stone average LOS is 3 
days. 



Infection average LOS is ap- 
proximately 6 days. 



Renal failure average LOS 
is approximately 10 days. 



Neoplasm with average LOS 
is approximately 8 days. 

Sign and symptoms average 
LOS is approximately 6 
days. 



For each of the remaining groups other than 
infection, both within and across the MDCs, a 
comprehensive list of all diagnoses relating to that 
specific definition was then formed. In the 
conceptualization of the medical side, based on 
clinical and statistical input, principal diagnoses that 
appeared in the CPHA data set were used (along with 
the ICD-9-CM Disease Listing, Volume 1) to form 
these seven groups. 

Next, the ICD-9-CM Volume III, Procedures: 
Tabular List and Alphabetic Index was reviewed, 
expanding the operating room procedure listing for 
each of the newly created surgical catergories. This 
resulted in a comprehensive clinical definition for 
each group. For example, Table 3.12 describes the 
expanded list for the kidney, ureter, and major 
bladder group. Once the operating room procedure 
categories were defined, a surgical hierarchy was 
established by staff physicians. 

Step 5 

When at least one procedure on a patient's record 
matches as operating room procedure on a predefined 
list, he or she is then assigned to one of the above 
operating room procedure categories. Because 
patients can have multiple operating room procedures 
per episode of care, a particular patient could be 
assigned to more than one of the categories. 
Therefore, based on clinical input and judgment, each 
operating-room procedure category was ranked in 
order of resource intensity and the patient assigned to 
the group including the most resource intensive 
category. This ranking is referred to as an operating 
room procedure hierarchy (shown in Table 3.13). 
How this hierarchy determines patient membership in 
surgical categories is illustrated in the following 
example: 

A hypothetical patient with a urinary tract 
disorder underwent several procedures 
during his/her hospital stay. On review of 
the procedures listed on the patient's medical 
abstract, two procedures (5733 transurethral 
biopsy of the bladder and 5779 other total 
cystectomy) matched pre-established 
definitions for MDC 1 1 operating room 
procedures. These two operating room 
procedures are in different surgical 
categories (i.e., 5779 in major bladder and 
5733 in transurethral). Therefore, assignment 
to a particular category is derived from the 
operating room procedure hierarchy. The 
patient is identified with the more resource 
intensive major bladder category, rather than 
the transurethral category. 



82 



Table 3.11 



Major Diagnostic Category 11: Diseases and disorders of the kidney and urinary tract, kidney, ureter, 

and major bladder category 



Procedure code Abbreviated CPHA English description Procedure code Abbreviated CPHA English description 



3924 Aorta-renal bypass. 

3955 Reimplan aberr renal ves. 

4052 Rad dissec periaort node. 

4053 Rad dissect iliac nodes. 

4054 Radical groin dissection. 

4059 Rad node dissection nec. 

*5501 Nephrostomy. 

*5502 Nephrostomy. 

*5511 Pyelostomy. 

5512 Pyelostomy. 

*5524 Renal biopsy nec. 

5529 Renal diagnost proc nec. 

5531 Renal les marsupializat. 

*5539 Loc destr renal les nec. 

*554 Partial nephrectomy. 

*5551 Nephroureterectomy. 

5552 Solitary kidney nephrect. 

5553 Rejected kidney nephrect. 

5554 Bilateral nephrectomy. 

5561 Renal autotransplant. 

557 Nephropexy. 

5581 Suture kidney laceration. 

5582 Close nephrost pyelost. 

5583 Close renal fistula nec. 

5584 Reduce renal pedicl tors. 

5585 Symphysiotomy. 

5586 Renal anastomosis. 

*5587 Correct ureteropelv junc. 

5589 Renal repair nec. 

*5591 Renal decapsulation. 

5597 Implant mechanic kidney. 

5598 Remov mechanical kidney. 

5599 Renal operation nec. 

*561 „ Ureteral meatotomy. 



*562 Ureterotomy. 

5633 Ureteral biopsy nec. 

5639 Ureteral DX procedur nec. 

5640 Ureterectomy nos. 

*5641 Partial ureterectomy. 

5642 Total ureterectomy. 

*5651 Form cutan ileoureterost. 

5652 Revis cutan ileoureteros. 

5661 Form cutan ureterostomy. 

5662 Revis cutan ureteros nec. 

5671 Urin diversion to bowel. 

5672 Revis ureteroenterostomy. 

5673 Nephrocystanastomosi nos. 

5674 Ureteroneocystostomy. 

5675 Transureteroureterostomy. 

5679 Ureteral anastomosis nec. 

5681 Intralum urete adhesioly. 

5682 Suture ureteral lacerat. 

5683 Ureterostomy closure. 

5684 Close ureter fistula nec. 

5685 Ureteropexy. 

5686 Remove ureteral ligature. 

5689 Repair of ureter nec. 

5692 Implant ureteral stimul. 

5693 Replace ureteral stimul. 

5694 Remove ureteral stimulat. 

5695 Ligation of ureter. 

5699 Ureteral operation nec. 

*5771 Radical cystectomy. 

*5779 Total cystectomy nec. 

5900 Retroperit dissect nos. 

*5901 Ureterolys for fibrosis. 

5902 Periren adhesiolys nec. 

5909 Periren/ureter incis nec. 



* indicates operating room procedure (ICD-9-CM codes) of kidney, ureter, and major bladder that occurred with any frequency in the CPHA data set. 



83 



Table 3.12 

Major Diagnostic Category 11: Disease and disorders of kidney and urinary tract, infection category 



Diagnosis code Abbreviated CPHA English description 



01600 TB of kidney-unspec. 

01601 TB of kidney-no exam. 

01 602 TB of kidney-exam unkn. 

01603 TB of kidney-micro DX. 

01604 TB of kidney-cult DX. 

01605 TB of kidney-histo DX. 

01606 TB of kidney-OTH test. 

01610 TB of bladder-unspec. 

01611 TB of bladder-no exam. 

01612 TB of bladder-exam unkn. 

01613 TB of bladder-micro DX. 

01614 TB of bladder-cult DX. 

01615 TB of bladder-histo DX. 

01616 TB of bladder-OTH test. 

01620 TB of ureter-unspec. 

01621 TB of ureter no exam. 

01622 TB of ureter exam unkn. 

01623 TB of ureter micro DX. 

01624 TB of ureter cult DX. 

01625 TB of ureter histo DX. 

01626 TB of ureter OTH test. 

01630 TB urinary nec-unspec. 

01631 TB urinary nec-no exam. 

01632 TB urinary nec-exam unkn. 

01633 TB urinary nec-micro DX. 

01634 TB urinary nec-cult DX. 

01635 TB urinary nec-histo DX. 

01636 TB urinary nec-OTH test. 

01690 GU TB nos-unspec. 

01691 GU TB nos-no exam. 

01692 GU TB nos-exam unkn. 

01693 GU TB nos-micro DX. 

01694 GU TB nos-cult DX. 



Diagnosis code Abbreviated CPHA English description 



01695 GU TB nos-histo DX. 

01696 GU TB nos-OTH test. 

03284 Diphtheritic cystitis. 

0786 Hem nephrosonephritis. 

0954 Syphilis of kidney. 

09811 GC cystitis (acute). 

09830 Chr GC upper GU nos. 

09831 GC cystitis, chronic. 

1200 Schistosoma haematobium. 

1372 Late effect GU TB. 

'59000 Chr pyelonephritis nos. 

59001 Chr pyeloneph w med necr. 

*59010 AC Pyelonephritis nos. 

59011 AC Pyelonephr w med necr. 

5902 Renal/perirenal abscess. 

5903 Pyelooreteritis cystica. 

*59080 Pyelonephritis nos. 

59081 Pyelonephrit in OTH dis. 

5909 Infection of kidney nos. 

5933 Stricture of ureter. 

*5950 Acute cystitis. 

5951 CHR interstit cystitis. 

*5952 Chronic cystitis nec. 

5953 trigunitis. 

5954 Cystitis in OTH dis. 

59581 Cystitis cystica. 

59589 Cystitis nec. 

*5959 Cystitis nos. 

597u Urethral abscess. 

*59780 Urethritis nos. 

59781 Urethral syndrome nos. 

59789 Urethritis nec. 

5990 Urin tract infection nos 



* Indicates principal diagnosis (ICD-9-CM codes) of infection that occurred with any frequency in the CPHA data set. 



84 



Table 3.13 

Operating room procedure category hierarchy 
ranked in descending order of importance for 
MDC 1 1 diseases and disorders of the kidney 
and urinary tract 



Rank 



Procedure category 



Step 6 

The stepwise construction of DRGs from these 
surgical and medical categories in MDC 1 1 is also 
illustrated with the "kidney, ureter and major 
bladder" and "infection" categories. The remaining 
step will summarize each of the groups formed by 
further subdividing "kidney, ureter, and major 
bladder" (surgical category) and "infection" (medical 
category). A similar process was followed for the 
remaining surgical and medical categories within 
MDC 1 1 to determine what if any independent 
variables should be selected for further subdivisions. 

Analysis of the kidney, ureter, and major bladder 
operating room procedure category. Next, a histogram 
and summary statistics were reviewed for the kidney, 
ureter and major bladder group. Figure 3.4 gives 
these histograms. The predominant research question 
asked was, what other variables might be useful in 
understanding resource consumption of patients 
undergoing kidney, ureter, and major bladder 
operating room procedures? 

Figure 3.4 

Length-of-stay distributions for patients in operating room procedure category, kidney, ureter, and 

major bladder 



1 Kidney transplant. 

2 Kidney, ureter, and major bladder. 

3 Prostatectomy. 

4 Other bladder. 

5 Transurethral. 

6 Urethra. 

7 Other operating room procedures. 



Value 



OBS 



Percent 



Cumulative 
percent 



Mean 12.62 



Standard 
deviation 6.67 



Number of 
patients 833 



1.00 


3 


.36 


.36 




2.00 


13 


1.56 


1.92 


*** 


3.00 


14 


1.68 


3.60 


*** 


4.00 


11 


1.32 


4.92 


** 


5.00 


18 


2.16 


7.08 


**** 


6.00 


44 


5.28 


12.36 


********** 


7.00 


45 


5.40 


17.77 


********** 


8.00 


87 


10.44 


28.21 


********************* 


9.00 


92 


11.04 


39.26 


********************** 


10.00 


71 


8.52 


47.78 


***************** 


11.00 


51 


6.12 


53.90 


************ 


12.00 


52 


6.24 


60.14 


************ 


13.00 


44 


5.28 


65.40 


********** 


14.00 


42 


5.04 


70.47 


********** 


15.00 


31 


3.72 


74.19 


******* 


16.00 


26 


3.12 


77.31 


****** 


17.00 


34 


4.08 


81.39 


******** 


18.00 


16 


1.92 


83.31 


*** 


19.00 


26 


3.12 


86.43 


****** 


20.00 


14 


1.68 


88.12 


*** 


21.00 


11 


1.32 


89.44 


** 


22.00 


12 


1.44 


90.88 


** 


23.00 


11 


1.32 


92.20 


** 


24.00 


14 


1.68 


93.88 


*** 


25.00 


5 


.60 


94.48 


* 


26.00 


4 


.48 


94.96 




27.00 


5 


.60 


95.56 


* 


28.00 


2 


.24 


95.80 




29.00 


5 


.60 


96.40 


* 


30.00 


4 


.48 


96.88 




31.00 


9 


1.08 


97.96 


** 


32.00 


3 


.36 


98.32 




33.00 


5 


.60 


98.92 


* 


34.00 


1 


.12 


99.04 




35.00 


3 


.36 


99.40 




36.00 


3 


.36 


99.76 




37.00 


2 


.24 


100.00 





85 



The classify algorithm was used to further partition 
the data set based on the operating room procedure 
categories formed in Step 3. The following set of 
independent variables was selected for defining 
potential subgroups: operating room procedure 
(DRGop), procedure (operll), principal diagnosis 
(dxl), secondary diagnosis (dx2), diagnostic category 
(dxcat), urinary tract infection (uti), pneumonia 
(pneumo), heart, alcohol, emergency (emerg), 
admitted through the emergency room (er), payor 
(payl), race, sex, discharge status (dstat), dead, 



admitted to an intensive care unit (adieu), admitted to 
a coronary care unit (adecu), admitted to a special 
care unit (adscu), etiology, dialysis, yes/no substantial 
comorbidity and/or complication (yncc), age, 
age 70cc. A more detailed listing of all independent 
variables used in this study is described in Section 2. 
Table 3.14 describes for kidney, ureter, and major 
bladder group the different variables explored, the 
number of groups formed by the classify algorithm; as 
well as, the corresponding percent reduction in 
explained variation for each of the variables. 



Table 3.14 

Independent variables reviewed in the partitioning process for kidney, ureter, and major bladder 



Variable name 



Number of 
observations 



Number of 
cells 



Number of 
groups 



Percent 
reduction 



Total sum 
of squares 



*AGE 833 

*AGE >5CC 833 

AGE>10CC 833 

AGE>15CC 833 

AGE >20CC 833 

AGE >25CC 833 

AGE >30CC 833 

AGE >35CC 833 

AGE >40CC 833 

AGE >45CC 833 

AGE >50CC 833 

AGE >55CC 833 

AGE >60CC 833 

AGE >65CC 833 

AGE >70CC 833 

AGE >75CC 833 

AGE >80CC 833 

YNCC 833 

DIALYSIS 833 

ETIOLOGY 833 

ADSCU 833 

ADCCU 833 

ADICU 833 

DSTAT 833 

SEX 833 

RACE 833 

DEAD 833 

PAY1 833 

ER 833 

EMERG 833 

ALCOHOL 833 

DRGOP 833 

HEART 833 

PNEUMO 833 

UTI 833 

OPERLL 833 

DXI 833 



88 
4 
4 
4 
4 
4 
4 
4 
4 
4 
4 
4 
4 
4 
4 
4 
4 
2 
2 
4 
2 
2 
2 
7 
2 
7 
2 

10 
2 
2 
1 

35 
2 
2 
2 
66 
76 



12.72 
7.56 
7.69 
7.62 
7.92 
9.49 
9.83 
10.91 
12.27 
12.12 
14.75 
15.39 
15.82 
14.03 
12.38 
10.86 
8.38 
7.56 
.00 
9.49 
.00 
.00 
5.58 
5.14 
.00 
.00 
.00 
9.53 
.00 
1.61 
.00 
18.97 
1.37 
.00 
1.92 
23.32 
20.28 



36,978.54 
36,976.27 
36,976.27 
36,976.27 
36,976.18 
36,976.27 
36,976.27 
36,976.27 
36,976.27 
36,976.27 
36,976.08 
36,976.18 
36,976.18 
36,976.08 
36,976.27 
36,976.27 
36,976.18 
36,976.08 
36,976.08 
36,976.27 
36,976.08 
36,976.08 
36,976.08 
36,975.98 
36,976.08 
36,976.27 
36,975.98 
36,976.27 
36,976.08 
36,976.08 
36,975.98 
36,977.96 
36,976.08 
36,975.98 
36,976.08 
36,976.67 
36,976.87 



86 



Tables 3.15 and 3.16 indicate that the principal 
diagnosis has a great deal of explanatory power in the 
kidney ureter, and major bladder group which is 
comprised of patients who underwent an operating 
room procedure on their kidney or ureter or bladder. 
Analysis of these patients revealed a long-stay group 
whose principal diagnoses were malignancy, resulting 
in the formation of a malignancy variable defined in 
Table 3.17. 



Table 3.15 

Kidney, ureter, and major bladder operating 
room category partitioning on the basis of 
principal diagnosis 





Group 


Number of 
observa- 
tions 


Mean 


OldilUalU 

deviation 


1 




353 


10.12 


5.18 


2 




264 


12.38 


6.07 


3 




158 


15.62 


6.59 


4 




58 


20.78 


7.88 



Table 3.16 

Suggested partitioning (4 groups) of kidney, ureter, and major bladder operating room procedure 

category on the basis of principal diagnosis 



Group Size Mean Independent variable Abbreviated CPHA English description 



1 


2.00 


22381 


Benign neoplasm uretha. 


1 


2.00 


59781 


Urethral syndrome nos. 


1 


2.00 


59780 


Urethritis nos. 


1 


2.00 


2367 


Unc behav neo bladder. 


1 


4.00 


5821 


Chr membrandous nephritis 


1 


6.00 


5839 


Nephritis nos. 


1 


7.00 


5845 


Lower nephron nephrosis 


1 


7.00 


86613 


Kidney disruption-open 


1 


7.00 


5829 


Chronic nephritis nos. 


1 


7.00 


2233 


Benign neoplasm bladder. 


8 


7.63 


5989 


Urethral stricture nos. 


3 


7.67 


7880 


Renal colic. 


1 


8.00 


V594 


Kidney donor. 


2 


8.50 


5930 


Nephrotosis. 


6 


8.50 


5932 


Cyst of kidney, acquired. 


28 


9.00 


5937 


Vesicoureteral reflux. 


1 


9.00 


5953 


Trigonitis. 


1 


9.00 


7533 


Kidney anomaly nec. 


1 


9.00 


86612 


Kidney laceration-open. 


6 


9.17 


5942 


Urethral calculus. 


3 


9.33 


7538 


Cystourethral anom nec. 


10 


9.40 


5990 


Urin tract infection nos. 


2 


9.50 


59080 


Pyelonephritis. 


2 


9.50 


86600 


Kidney injury nos-closed. 


1 


10.00 


5935 


Hydroureter. 


258 


10.68 


5921 


Calculus of ureter. 


8 


10.75 


5939 


Renal ureteral dis nos 


1 


11.00 


4473 


Renal artery hyperplasia. 


1 


11.00 


7883 


Incontinence of urine. 


7 


11.43 


5933 


Stricture of ureter. 


1 


12.00 


23691 


Unc behav neo kidney. 


1 


12.00 


7910 


Porteinuria. 


174 


12.05 


5920 


Calculus of kidney. 


7 


12.43 


59000 


Chr pyelonephritis nos. 


8 


12.50 


7532 


Congen ureteral obstruct. 


4 


12.75 


7534 


Ureteral anomaly nec. 


8 


12.88 


5997 


Hematuria. 


1 


13.00 


2230 


Benign neophasm kidney. 



419-177 0-84—7 



87 



Table 3.16— Continued 

Suggested partitioning (4 groups) of kidney, ureter, and major bladder operating room procedure 

category on the basis of principal diagnosis 



Group Size Mean Independent variable Abbreviated CPHA English description 



1 


13.00 


5951 


Chr interstit cystitis. 


1 


13.00 


4039 


Hypertens renal dis nos. 


6 


13.00 


5902 


Renal peirenal abscess. 


3 


13.33 


586 


Renal failure nos. 


33 


13.52 


5934 


Ureteric obstruction nec. 


5 


13.60 


7531 


Cystic kidney disease. 


1 


14.00 


8670 


Bladder/urethra inj-clos. 


1 


14.00 


5849 


Acute renal failure nos. 


2 


14.00 


5830 


Proliferat nephritis nos. 


16 


14.38 


59389 


Renal ureteral dis nec. 


8 


14.38 


1891 


Malig neo renal pelvis. 


23 


14.43 


591 


Hydrohephrosis. 


4 


14.75 


5929 


Urinary calculus nos. 


1 


15.00 


1885 


Mai neo bladder neck. 


2 


15.50 


4030 


Mai hypertens renal dis. 


1 7 


15.82 


1892 


Malign neopl ureter. 


1 


16.00 


59000 


Chr pyeloneph w med necr. 


77 


16.17 


1890 


Malig neopl kidney. 


1 


17.00 


44211 


Renal artery aneurysm. 


2 


17.00 


59381 


Renal vascular disorder. 


2 


17.00 


9975 


Surg compl-urinary tract. 


2 


17.50 


86602 


Kidney laceration-closed. 


1 


18.00 


1899 


Mai neo urinary nos. 


1 


18.00 


7888 


Extravasation of urine. 


5 


18.60 


34461 


Neurogenic bladder. 


1 


19.00 


5952 


Chronic cystitis nec. 


2 


19.50 


4401 


Renal artery atheroscler. 


4 


19.75 


585 


Chronic renal failure. 


32 


19.78 


1889 


Malig neo bladder nos. 


1 


20.00 


1893 


Malign neopl urethra. 


3 


20.33 


59010 


Ac pyelonephritis nos. 


2 


22.00 


5819 


Nephrotic syndrome nos. 


1 


23.00 


1981 


Sec malig neo urin nec. 


2 


24.00 


1888 


Malig neo bladder nec. 


2 


26.50 


5834 


Rapidly prog nephrit nos. 


1 


29.00 


V420 


Kidney transplant status. 


1 


31.00 


1980 


Second malig neo kidney. 


1 


33.00 


2337 


Ca in situ bladder. 



88 



Table 3.17 

Definition of malignancy used in partitioning of 
kidney ureter, and major bladder operating-room 
procedure category 



Diagnosis Abbreviated CPHA English description 



1880 Mai neo bladder-trigone 

1881 Mai neo bladder-dome 

1882 Mai neo bladder-lateral 

1883 Mai neo bladder-anterior.... 

1884 Mai neo bladder-post 

1885 Mai neo bladder-neck 

1 886 Mai neo ureteric-ori ce 

1887 Malig neo urachus 

1888 Malig neo bladder nec 

1889 Malig neo bladder nos 

1890 Malig neopl kidney 

1 891 Malig neo renal pelvis 

1892 Malign neopl ureter 

1893 Malign neopl urethra 

1894 Mai neo paraurethral 

1898 Mai neo urinary nec 

1 899 Mai neo urinary nos 

1980 Second malig neo kidney.. . 

1981 Sec malig neo urin nec 

2230 Benign neoplasm kidney. ... 

2231 Benign neo renal pelvis 

2232 Benign neoplasm ureter 

2233 Benign neoplasm bladder. . 
22381 Benign neoplasm urethra... 
22389 Benign neo urinary nec 

2239 Benign neo urinary nos 

2337 Ca in situ bladder 

2339 Ca in situ urinary nec 

2367 Unc behav neo bladder 

23690 Unc behav neo urinar nos. 

23691 Unc behav neo kidney 

23699 Unc behav neo urinar nec. 

2394 Bladder neoplasm nos 

2395 Other gu neoplasm nos 



Each of the groups formed was then considered for 
further partitioning. The malignancy group was of 
relatively small size with 147 observations. If an 
additional split were to be made, the end result would 
be two very small terminal groups. Therefore the 
group was not further partitioned. 

A closer examination was made of the kidney, 
ureter, and major bladder patients without malignancy 
to determine further potential subdivisions. The 
number of groups formed by the algorithm and the 
corresponding percent reduction in unexplained 
variation for each of the independent variables 
contained on the data set are shown in Table 3.18. 

Given these results, several things were considered 
in further partitioning the non-malignancy group. The 
independent variables chosen to define potential 
subgroups were age >50 cc, age >55, age >60, age 
>65 cc, age >70, procedure (operll), and operating 
room procedure (DRGop). Descriptive statistics for 
each of these independent variables are summarized in 
Table 3.19. Both the procedure and operating room 
procedure variables were ruled out for further 
partitioning. 



89 



Table 3.18 

Independent variables reviewed in the partitioning process for kidney, ureter, and major bladder 

without malignancy 





Variable name 


Number of 
observa- 
tions 


Number of 
cells 


Number of 
groups 


Percent 
reduction 


Total sum 
of squares 






686 


88 


3 


9.78 


25,917.53 


AGE >5CC 




686 


4 


2 


9.93 


25,915.70 


AGE >10CC , 




686 


4 


2 


9.93 


ot o 4 C ^O 

25,915.70 


AGE >15CC 




686 


4 


2 


9.93 


AC f\4\ C "TO 

25,915.70 


a /"^ r~" ^ rtrt/**^^ 




686 


4 


2 


10.02 


25,915.61 


A /"n r™ - /"» r - /">/■> 






4 


3 


1 1.09 


25,915.70 


AGE >30CC , 




686 


4 


3 


11.04 


25,915.61 


AGE >35CC , 




686 


4 


3 


11.18 


25,915.61 


AGE >40CC 




686 


4 


3 


12.42 


/■> i— f\AC CO 

25,915.52 


AGE >45CC 




686 


4 


4 


13.06 


i-"> c f\4 C O A 

25,915.61 


AGE >50CC 




686 


4 


3 


15.18 


25,915.61 


AGE >55CC 




686 


4 


3 


15.47 


25,915.61 


AGE >60CC 




686 


4 


3 


16.58 


r\ f- f\ A C C 4 

25,915.61 


AGE >65CC 




686 


4 


3 


15.32 


25,91 5. AJ 






coe 


4 


J 


1 o. 1 n 

1 J. IU 


OC Q1 C Ai 






CQC 


4 


o 

£ 


11 1 K 

1 1.10 


OK Qi C 7fi 






eoc 


4 




1 n oo 


OC Q1 C C1 
£0,91 D.Ol 






eac 


o 

£ 


o 
d. 


y.yj 


OC QI C CO 


riiAi vcic 




fioe 




1 


.uu 


OC Q1 C CO 


CTini nr;v 




COfi 


o 

O 


4 
1 


fin 
.UU 


OC Q1 C CI 


ADSCU 




686 


2 


1 


.00 


25,915.52 


APOCU 




686 


2 


1 


.00 


25,915.43 


AUIOU 




686 


2 


2 


4.87 


25,915.52 


UoTAT 




686 


7 


2 


6.01 


25,915.70 


or V 






2 


1 


.00 


25,915.52 


O A 1 — 






7 


1 


.00 


25,915.52 


DEAD 




686 


2 


1 


.00 


25,915.52 


DAW4 






9 


2 


8.83 


25,915.70 


ER 




686 


2 


1 


.00 


25,915.52 


EMERG 




686 


2 


2 


1.51 


25,915.52 


a i prM-jPii 






H 
1 


4 
1 


.Uu 


oc oi c ao 


DRGOP 




686 


41 


4 


16.00 


25,916.34 


HEART 




686 


2 


1 


.00 


25,915.43 


PNEUMO 




686 


2 


1 


.00 


25,915.43 


UTI 




686 


2 


2 


2.32 


25,915.52 


0PER11 




686 


54 


4 


16.82 


25,916.16 


DX1 




686 


60 


4 


12.53 


25,916.07 



90 



Table 3.19 

Kidney, ureter, and major bladder without malignancy 



Variable 



Group 



Number 
observed 



Mean 



Standard 
deviation 



Age >50CC... 

Age >55CC... 

Age >60CC... 

Age >65CC... 

Age >70CC... 

Age > 70CC 
Operll 

DRGop 



1 


277 


9.34 


4.26 


2, 3 


301 


12.22 


6.11 


4 


108 


16.32 


7.34 


1 


331 


9.63 


4.74 


2, 3 


264 


12.52 


5.93 


4 


91 


16.86 


7.62 


1 


385 


9.86 


4.92 


2, 3 


230 


12.90 


5.98 


4 


71 


17.82 


7.68 


1 


420 


10.06 


4.94 


2, 3 


212 


13.29 


6.36 


4 


54 


18.24 


7.79 


1 


454 


10.20 


5.04 


2, 3 


200 


14.15 


6.82 


4 


32 


17.75 


7.53 


1* 


454 


10.20 


5.04 


2 


232 


14.65 


7.01 


1 


34 


6.18 


2.97 


2 


488 


10.92 


5.33 


3 


154 


14.53 


6.85 


4 


10 


25.10 


5.45 


1 


35 


5.89 


2.89 


2 


453 


10.79 


5.22 


3 


173 


14.10 


6.89 


4 


25 


19.68 


6.45 



* The maximum number of subgroups specified for AUTOGRP to recommend was two. 



These independent variables take on many different 
values and it is an artifact of the variance reduction 
algorithms that many subgroups can be created when 
there are a large number of different values of the 
patient characteristic. These groups formed were not 
judged clinically coherent. Further, in accordance 
with guidelines described in Section 2, partitions 
based on age should be consistent with DRG 
definitions for a particular MDC, unless there is a 
specific clinical rationale to do otherwise. Therefore, 
the group without malignancy was further split on 
age >70 cc. A two way split was implemented over 
the three way split in order to keep the number of 
terminal groups in the entire DRG system a 



manageable size. In addition, the difference in 
variance reduction resulting from the change from a 
three-way split to a two-way split was found to be 
small. This resulted in the construction of DRGs SOS- 
SOS. 

To further clarify the construction of DRGs, let us 
examine the Infection category on the medical side of 
the tree. A histogram and summary statistics for the 
Infection Group were reviewed. (Figure 3.5). Table 
3.20 describes, for the Infection group, the different 
independent variables explored, the number of groups 
formed by the classify algorithm, and the 
corresponding percent reduction in explained 
variation for each of these variables. 



91 



Figure 3.5 

Length-of-stay distributions for medical patients with an infection 



Standard Number of 

Value CBS Percent Cumulative percent Mean 6.10 deviation patients 

5.03 2,261 



1.00 


209 


9.24 


9.24 


************************* 


2.00 


293 


12.96 


22.20 


******************************** 


3.00 


311 


13.75 


35.96 


************************ 
******************** 


4.00 


275 


12.16 


48.12 


*************** 


5.00 


237 


10.48 


58.60 




6.00 


170 


7.52 


66.12 


************ 


7.00 


149 


6.59 


72.71 


.......... 


8.00 


116 


5.13 


77.84 


......... 


9.00 


104 


4.60 


82.44 


******** 


10.00 


65 


2.87 


85.32 


****** 


11.00 


58 


2.57 


87.88 


* * * * 


12.00 


53 


2.34 


90.23 


* * * * 


13.00 


40 


1.77 


91.99 


* * * 


14.00 


40 


1.77 


93.76 


* * * 


15.00 


29 


1.28 


95.05 


.* 


16.00 


19 


.84 


95.89 


* 


17.00 


20 


.88 


96.77 


* 


18.00 


9 


.40 


97.17 




19.00 


4 


.18 


97.35 




20.00 


5 


.22 


97.57 




21.00 


14 


.62 


98.19 




22.00 


6 


.27 


98.45 




23.00 


6 


.27 


98.72 




24.00 


2 


.09 


98.81 




25.00 


5 


.22 


99.03 




26.00 


3 


.13 


99.16 




27.00 


2 


.09 


99.25 




28.00 


3 


.13 


99.38 




29.00 


2 


.09 


99.47 




30.00 





.00 


99.47 




31.00 


2 


.09 


99.56 




32.00 


1 


.04 


99.60 




33.00 


2 


.09 


99.69 




34.00 


1 


.04 


99.73 




35.00 


1 


.04 


99.78 




36.00 


2 


.09 


99.87 




37.00 


3 


.13 


100.00 





Table 3.20 

Independent variables reviewed in the partitioning process for infection 





Variable name 


Number of 
observations 


Number of 
cells 


Number of 
groups 


Percent 
reduction 


Total sum 
of squares 


*AGE 




2,261 


99 


3 


14.98 


57,275.41 


AGE >5CC 




2,261 


4 


2 


6.98 


57,273.17 


AGE >10CC 




2,261 


4 


3 


8.42 


57,273.12 


AGE >15CC 




2,261 


4 


3 


8.69 


57,273.12 


AGE >20CC 




2,261 


4 


3 


10.03 


57,273.12 


AGE >25CC 




2,261 


4 


3 


11.62 


57,273.12 


AGE >30CC 




2,261 


4 


3 


12.62 


57,273.12 


AGE >35CC 




2,261 


4 


3 


13.23 


57,273.12 


AGE >40CC 




2,261 


4 


3 


14.56 


57,273.12 


AGE >45CC 




2,261 


4 


3 


15.14 


57,273.12 


AGE >50CC 




2,261 


4 


3 


15.10 


57,273.12 


AGE >55CC 




2,261 


4 


4 


16.16 


57,273.17 


AGE >60CC 




2,261 


4 


4 


16.41 


57,273.17 


AGE >65CC 




2,261 


4 


4 


15.65 


57,273.17 


AGE >70CC 




2,261 


4 


4 


15.76 


57,273.17 


AGE >75CC 




2,261 


4 


4 


14.75 


57,273.17 


AGE >80CC 




2,261 


4 


3 


12.32 


57,273.12 


YNCC 




2,261 


2 


2 


6.76 


57,273.07 


DIALYSIS 




2,261 


2 


1 


.00 


57,273.03 


ETIOLOGY 




2,261 


2 


1 


.00 


57,273.03 


ADSCU 




2 261 


2 


1 


.00 


57,273.03 


ADCCU 




2,261 


2 


1 


.00 


57,273.03 


ADICU 




2 261 


2 


2 


1.96 


57,273.07 


DSTAT 




2 261 


8 


2 


7.12 


57,273.31 


SEX 




2 261 


2 


1 


.00 


57,273.07 


RACE 




2 261 


7 


1 


.00 


57,273.17 


DEAD 




2 261 


2 


1 


.00 


57,273.07 


PAY1 




2 261 


11 


2 


12.90 


57,273.17 


ER 




2 261 


2 


2 


1.85 


57,273.07 


EMERG 




2 261 


2 


2 


1.43 


57,273.07 


ALCOHOL 




2,261 


2 


1 


.00 


57,273.07 


HEART 




2,261 


2 


2 


1.85 


57,273.07 


PNEUMO 




2,261 


2 


1 


.00 


57,273.07 


UTI 




2,261 


2 


1 


.00 


57,273.07 


OPER11 




2,261 


117 


5 


17.82 


57,273.88 


DX1 




2,261 


22 


2 


2.54 


57,273.31 



Because, a substantial percentage of reduction in 
explained variation was achieved with procedure 
(operll), payor source (payl), age, and age70cc, these 
variables were evaluated individually as candidates 
for further subdividing this category. The descriptive 
statistics are summarized in Table 3.21. Pay source 
was not further evaluated as it is a system variable not 
related to the care process. The remaining variables in 
the list were discarded as candidates for the 
partitioning of this group at this level of the tree. It 
was decided, however, to split further the Infection 
Group of the urinary system into two parts, similar to 
those suggested by the classify algorithm, namely a 



group of patients 18 years of age and over and a 
group of patients under 17 years of age. 

A closer examination was made of the 
characteristics of the two Infection Groups formed, 
are 17 years of age and 18 years of age and over. 
Table 3.22 describes the number of groups formed by 
the classify algorithm and the explained variation for 
each of the variables. No further partitioning was 
suggested by the classify algorithm for the 0-17 years 
of age group. However, the 18 years of age and over 
Infection Group was partitioned on age70cc. 
Descriptive statistics are summarized in Table 3.23. 



93 



Table 3.21 
Infection 



Group nam© 


Group 


Number 
observed 


Mcdn 


Standard 
deviation 


Operll 


1 


788 


4.75 


4.29 




2 


1,256 


6.08 


4.33 




3 


147 


8.72 


5.49 




4 


60 


14.50 


8.24 




5 


10 


24.90 


8.37 


Age >70CC 


3 1 


1,222 


4.52 


3.47 




2 


474 


6.55 


4.91 




3 


282 


7.96 


5.65 




4 


283 


10.27 


6.83 


Age >70CC* 


1 


1,222 


4.52 


3.47 




2 


1,039 


7.95 


5.89 






1,398 


4.66 


3.69 




2 (ages 59-79) 


566 


7.63 


5.32 




3 (ages 80-99) 


297 


9.93 


6.80 


Payl 


1 


1,455 


4.75 


3.65 




2 


806 


8.52 


6.16 



The maximum number of subgroups specified for AUTOGRP to recommend was two. 

Table 3.22 

Independent variables reviewed in the partitioning process for infection with age 0-17, and with age 

18 and over 



Variable name 



Number of 
observations 



Number 
cells 



Number of 
groups 



Percent 
reduction 



Total sum 
of squares 



Age 0-17 

* Age 

Age >5CC 

Age >10CC 

Age >15CC 

Yncc 

Dialysis 

Etiology 

Adscu 

Adccu 

Adieu 

Dstat 

Sex 

Race 

Dead 

Payl 

ER 

Emerg 

Alcohol 

Drgop 

Heart 

Pneumo 

Uti 

Operll 

Dxl 



355 


18 


3 


6.96 


4,139.17 


355 


4 


2 


4.80 


4,139.16 


355 


4 


2 


4.80 


4,139.16 


355 


4 


2 


4.80 


4,139.16 


355 


2 


2 


4.80 


4,139.16 


355 


1 







4,139.16 


355 


1 







4,139.16 


355 


2 







4,139.16 


355 


1 







4,139.16 


355 


1 







4,139.16 


355 


3 







4,139.16 


355 


2 







4,139.16 


355 


7 


2 


2.46 


4,139.16 


355 


1 


1 





4,139.16 


355 


8 


2 


1.40 


4,139.16 


355 


2 


2 


2.44 


4,139.16 


355 


2 


2 


3.69 


4,139.16 


355 


1 







4,139.16 


355 


1 







4,139.16 


355 


i 







4,139.16 


355 


2 







4,139.16 


355 


2 







4,139.16 


355 


29 


3 


18.07 


4,139.16 


355 


15 


3 


4.10 


4,139.16 



94 



Table 3.22— Continued 

Independent variables reviewed in the partitioning process for infection with age 0-17, and with age 

18 and over 

Variable name Number of Number of Number of Percent Total sum 

name observations cells groups reduction of squares 



Age 18 and over 



* Ano 


1 QOfi 


O I 


o 
o 


I J. I 


en QQO oo 


Ana ^.PP 


1 Q0.fi 


o 

c 


o 
c. 


O.Do 


ca QQi on 


Ana ^>10PP 


1 QOfi 


o 
c. 


o 
c. 


^ fiO 
D.Do 


CO. QQi OQ 


An** ^>i^nn 


1 Qflfi 




o 

£. 


^ fiO 


cn QQ1 Ovl 

ou,oy i .oh 


Ana >> OOPP 


1 Q0.fi 


A 
*t 


O 

c. 


A A~7 
O.Hf 


cn on-i o>1 

ou.oy 1 .OH 


Ana ^ oc .PP, 


1 QOfi 


A 
H 


o 

£ 


7 49 
/ .He. 


Cn QQi Qyl 

ou,oy i .oh 




1 QOfi 


A 
H 


o 


Q C.P. 

y.oo 


QQI Ovl 

ou.oy 1 .oh 


Ana s^Arr 


1 QOfi 


A 
H 


o 
o 


I U.oO 


Crt QQi Qyi 

ou,oy i .oh 


A no s40f!r 


1 QOfi 


A 


o 
o 


1 -1 QO 

i i .yo 


en qqi Ovl 

ou.oy i .oh 


A no sARflP. 


1 QOfi 


A 


o 
o 


I o.U 1 


en QQi q>i 

ou,oy i .oh 


A no s^flfT 1 


1 QOfi 


A 
H 


o 


1 o no 
l o.Uo 


en on-i o/l 

ou.oy 1 .OH 


Ano ^c.RPP 


1 QOfi 


A 
H 


o 
o 


\0.\c. 


en qqi o>i 

ou.oy i .oh 


Ano \ fiOPP 


1 QOfi 


A 
H 


o 
o 


I o.*H 


cn QQi o>l 

ou.oyi .oh 


Ano ^.fi^nn 


1 QOfi 


A 


H 


1 Q fi7 


cn QQi Ovl 

ou,cjy 1 .OH 


Ano ^70PP 


1 QOfi 


A 


*f 


i o.yo 


cn QQi 

ou,oy i .oy 


Ana >>7RCC 


1 QOfi 


A 


*f 




en QQi OQ 

ou,oy i .jy 


Ano ">P,0P,P 


1 QOfi 


A 

*T 


o 
o 


1 Q7 

i u.y / 


RCl P.Q1 Ovl 

ou,oy i .oh 




1 QOfi 


o 
c. 




c. «o 

D.DO 


CO QQi OQ 

ou.oyi .^y 


Oislucic 


1 QOfi 


o 
c. 


1 




C.O. QQ1 OA 


Ftinlnnw 




A 


o 

£ 


n 

u 


cn QQi OA 
DU,oy 1 .dH 


Aricn i 


1 QOfi 


O 
c. 


I 


n 
U 


RCi OQ1 OQ 


AHm i 


1 QOfi 


o 
c. 


1 
I 


n 
U 


cn QQi Oyi 

ou,oy i .dH 


AHipi i 


1 QOfi 


o 

£. 


O 


1 QA 

i .y*f 


ou,t>y i .c\5 


Dstat 


1 906 


8 


2 


6.54 


50 8Q1 4Q 


Sex 


1,906 


2 


1 





50,891.29 


Race 


1,906 


7 


1 





50,891.39 


Dead 


1,906 


2 


• 1 





50,891.29 


Payl 


1,906 


11 


2 


11.67 


50,891.44 


Er 


1,906 


2 


2 


1.32 


50,891.29 


Emerg 


1,906 


2 


2 


1.15 


50,891.29 


Alcohol 


1,906 


2 


1 





50,891.29 


Drgop 


1,906 


1 


1 





50,891.24 


Heart 


1,906 


2 


2 


1.74 


50,891.29 


Pneumo 


1,906 


2 


1 





50,891.29 


Uti 


1,906 


2 


1 





50,891.29 


Operll 


1,906 


114 


5 


17.90 


50,891.11 


Dxl 


1,906 


22 


3 


4.68 


50,891.34 



Table 3.23 
Infection 



Variable name Group Number Mean deviation 



Age 1 8 and over 



Operll 


1 


658 


5.21 


4.44 




2 


1,038 


6.41 


4.45 




3 


141 


8.84 


5.12 




4 


59 


14.58 


8.30 




5 


10 


24.90 


8.37 


Age >70CC 


1 


923 


4.87 


3.55 




2 


418 


6.69 


4.91 




3 


282 


7.96 


5.65 




4 


283 


10.27 


6.83 


Age >70CC* 


1 


923 


4.87 


3.55 




2 


983 


8.08 


5.92 



* The maximum number of subgroups specified for AUTOGRP to recommend was two. 



95 



Section 4: Replication substudy 
Introduction 

As described in Section 2, the guidelines developed 
for the formation of DRGs require that partitions be 
based on "clinically coherent" groups of principal 
diagnoses and operating room procedures. For the 
purpose of this project, the concept of clinical 
coherence was operationally defined in the following 
manner: Patients in the same DRG can be expected to 
evoke a set of clinical responses which results in a 
similar pattern of resource use. While this requirement 
insured that DRG definitions would be interpretable 
from a clinical perspective, it also introduced a high 
level of subjectivity into the process of forming 
groups. To the extent that a physician's decisions 
regarding the clinical coherence of a set of patient 
attributes are related to his own patterns of practice, 
DRG definitions are dependent on the group of 
physicians employed to construct them. 

For many applications of the DRGs, especially 
case-mix reimbursement, the particular composition of 
the groups has very serious implications for public 
policy and institutional management. It is therefore 
important to assess the extent to which different teams 
of physicians, working independently and according 
to the same guidelines, would agree in their 
partitioning of patient records into DRGs. 

For this purpose, a substudy was conducted by 
three different teams of physicians that independently 
formed DRGs from one Major Diagnostic Category: 
Diseases and Disorders of the Respiratory System. 
All teams were instructed to follow the same 
guidelines. Agreement was operationally defined in 
terms of the teams grouping together similar sets of 
patients and could be achieved in one of two ways. 
First, the teams could use the same patient attributes 
to define DRGs. Second, the teams could form DRGs 
on the basis of different variables and still achieve 
agreement if there were comparability in the content 
of groups between schemes. For example, one scheme 
may partition a group of operating room procedures 
on age and another on principal diagnosis. If there is 
a strong association between age and principal 
diagnosis (e.g. certain diseases are more prevalent in 
younger persons than in old), then the groups formed 
on the basis of age in the first scheme may in fact 
contain many records in common with a parallel 
group formed on the basis of principal diagnosis in 
the other scheme. 

The primary objectives of the substudy were: 

• To describe differences in DRG definitions among 
the schemes in terms of the variables used to 
construct them. 

• To assess the extent to which the DRGs defined by 
the respective teams contain comparable sets of 
patients, regardless of the variables used to define 
them. 



A secondary objective was to discuss the implications 
of the different schemes in the context of their 
application for inter-institutional comparisons. 

Methods 

Composition of teams 

The three teams were composed of members from 
the project's Steering Committee'' Each team had at 
least two physicians in addition to one or more 
persons with an educational background or experience 
in one of the following fields: health economics, 
health services research, statistics, medical records. 

Specifically, the composition of the teams was as 
follows: 

Team A: 2 internists 

1 surgeon 

2 health services researchers 
1 nurse 

Team B: 1 internist 

1 general practitioner 
1 health economist 
1 statistician 

1 medical records specialist 

Team C: 1 psychiatrist 

2 internists 

1 statistician 

1 health services researcher 
It should be noted that Team A includes the group of 
physicians employed by Yale to construct the DRGs. 

Data 

The data were a random sample of discharges 
drawn from the CPHA data base with a principal 
diagnosis included in Major Diagnostic Category 4: 
Diseases and Disorders of the Respiratory System. 
The variables included in this data base were 
described in Section 2. 

Material and support provided to teams 

All teams were provided with: 

• The set of guidelines for formation of DRGs 
described in Section 2. 

• A list of all principal diagnoses included in MDC 4. 

• Summary statistics (number of patients, mean length 
of stay, standard deviation length of stay) for each 
principal diagnosis. 

• Results obtained from applying the A.I.D. 
algorithm to the data using length of stay as the 
dependent variable and principal diagnosis and 
operating room procedure as the independent 
variables. 



96 



Each team was instructed not to discuss its analysis 
with members from the other teams or from the Yale 
research staff. However, each team could consult 
with anyone they chose outside the project (such as 
physician specialists). 

Technical support in the way of generating 
computer output was provided by members of the 
Yale staff. Yale staff were permitted only to respond 
to special requests for information from the data base. 
They were specifically instructed not to provide any 
interpretation of the findings. 

For the most part, the teams met to discuss their 
analyses immediately preceding regularly scheduled 
steering committee meetings in Washington, D.C. All 
supporting computer work was performed on an IBM 
370-158 computer, located at the Yale Computer 
Center, and output distributed to team members 
during the individual team meetings. 

Results 

Descriptive summary 

Each team of physicians independently partitioned 
Diseases and Disorders of the Respiratory System 
into patient groups. Their approaches to classification 
are hereafter referred to as Scheme A, Scheme B, and 
Scheme C, and are summarized in the tree diagrams 
presented in Figures 4. 1 and 4.2. Figure 4. 1 describes 
the surgical partitioning and Figure 4.2 the medical 
partitioning. Geometric symbols (diamond, circle, 
hexagon) represent decision points in the division 
process and contain the variable used in the decision. 
Lines emanate from the symbol indicating how the 
groups were split on the basis of that variable. Final 



groups of DRGs are represented by squares. Inside 
each square is the sequential DRG number. The 
specific diagnostic and procedure codes assigned to 
each DRG are contained in the Reference Lists in 
Appendix IV. 

Descriptive statistics corresponding to the groups 
are given in Table 4. 1 . Specifically, this table presents, 
for each DRG within each scheme, the DRG 
number, a brief description of the group in terms of 
the variables used to define it, the number of 
observations from the sample data base that are 
included in the group, the mean or average length of 
stay (LOS), the standard deviation (s.d.), and the 
coefficient of variation (c.v. = s.d. /mean). The order 
of the groups within a scheme may be rearranged to 
facilitate comparisons between schemes. 

In terms of general structure, Team A partitioned 
the diseases and disorders of the Respiratory System 
into the largest number of DRGs, 23, followed by 
Team B with 20, and Team C with 17. Teams A and 
B created only 3 and 2 groups, respectively, on the 
surgical side, that accounted for 5.6 percent of the 
discharges in the sample data base. In contrast, Team 
C created 7, almost half their total number. For the 
most part, the teams appeared to follow the 
guidelines. The one exception was Team C's initial 
partitioning of medical patients on the use of a 
respirator instead of on principal diagnosis. It is 
observed that Scheme C exhibits the greatest 
explanatory power (20 percent), and Scheme B the 
least (18 percent), although the differences among the 
schemes are not large. 

A more detailed comparison of the schemes' 
partitioning of medical and surgical patients is given 
below. 



97 



Figure 4-2 



Comparison of Classfication Schemes: 
Medical Partitioning 



SCHEME A 




SCHEME B 




CC Complications and/or 

comorbidities 

YCC with CC 
NCC without CC 
YNCC with or without CC 



UK IOC 3K. 11C 



99 



Table 4.1 

Number of discharges, mean, and standard deviation of length of stay, and coefficient of variation by 

DRG within each classification scheme 





Scheme A 








Scheme B 








Scheme C 








DRG 
No. 


Description N gf 


Mean 
LOS 


LOS CV. 


DRG 
No. 


Description ^JJ™" 


Mean 
LOS 




DRG 
No. 


Description 


Num- 
ber 


Mean 

LOS 


LOS «f. 



1A Major Chest Operating Room Pro- 1094 15.36 8.47 .55 
cedures 



2A Operating Room Procedures on 271 9.90 7.44 .75 

the Respiratory System Except 

Major Chest w/o c.c 
3A Operating Room Procedures on 206 15.13 8.91 .59 

the Respiratory System Except 

Major Chest and/or c.c 



1B Resection Procedures 



554 16.62 7.56 .45 



2B Other Respiratory Operating 1017 13.17 8.90 .68 
Room Procedures 



5C Invasive or Radical Procedures. 181 13.36 7.54 .56 
Pneumothorax. Sarcoid. Fibro- 
sis, and Sign and Symptoms 

6C Invasive or Radical Procedures, 468 17.43 7.96 .46 
Cancers 

7C Invasive or Radical Procedures, 127 17.50 8.15 .47 

Bacterial Pneumonia. T.B., 

C.O.P.D.. and P.E 

1C Minor Procedures. Diagnostic and 58 7.62 5.25 .69 

Sign and Symptoms 

2C Minor Procedures. Pneumothorax, 179 9.47 7.72 .82 
Sarcoid. Benign Neoplasm, Fi- 
brosis, Upper Respiratory infec- 
tion 



3C Minor Procedures. Cancers 



453 13.28 8.34 .63 



4A Bronchitis, and Asthma age 0-14 2602 3.67 2.26 .62 



5A Bronchitis and Asthma age 2817 5.77 3.84 .67 
>=15 w/o c.c 



3B Asthma and Acute Bronchitis, 2649 3.66 2.24 .61 
Age 0-15 

4B Asthma and Acute Bronchitis. 1809 5.31 3.62 .68 
Age 16-49 



4C Minor Procedures, Bacterial Pneu- 105 15.70 10.18 .65 

monia, T.B.. C.O.P.D.. P.E 

8C Without Respirator, Bronchitis and 2809 3.65 2.28 .62 

Asthma. Age < = 1 5 

11C Without Respirator. Age 16-69 4090 5.29 3.76 .71 

with c.c. Bronchitis and 

Asthma 



6A Bronchitis and Asthma age 1709 8.35 5.86 .70 
> = 15 and/or c.c c.c 



7A Simple pneumonia age <70 w/o 3448 5.99 4.09 .68 



5B Asthma and Acute Bronchitis, 1310 6.71 4.30 .68 

Age 50-99. Without c.c 

6B Asthma and Acute Bronchitis, 1263 9.03 6.06 .67 

Age 50-99. and/or c.c 



7B Pneumonia, Age 0-15 



1787 5.13 3.64 .71 



14C Without Respirator. Age 16-69 3498 7.82 5.64 .72 
with c.c, age >=70, Bronchi- 
tis and Asthma 

9C Without Respirator. Pneumonia, 1775 5.07 3.52 .69 
Age < =15 



8B Pneumonia. Age 16-49, without 1042 6.47 4.12 .64 



12C Without Respirator, Age 16-69 3084 7.19 5.12 .71 
without c.c, Pneumonia, 
C.O.P.D 



8A Simple pneumonia age >=70 3173 10.13 7.08 .70 
and/or c.c 



10B Pneumonia. Age 50-99. without 1415 8.77 5.56 .63 
c.c 

9B Pneumonia, Age 16-49, and/or 389 9.08 6.28 .69 



10A COPD w/o c.c 
11 A COPD and/or c.c 
12A Neoplasm 



1984 7.76 5.73 .74 
2123 10.00 6.90 .69 
2415 10.05 8.16 .81 



11B Pneumonia. Age 50-99. and/or 1906 11.26 7.70 



14B Chronic Obstructive Pulmonary 1924 7.81 5.75 .74 

Disease without c.c 
15B Chronic Obstructive Pulmonary 2061 10.00 6.91 .69 

Disease, and/or c.c 
12B Neoplasm 1877 9.69 8.24 .85 



15C Without Respirator. Age 16-69 5763 10.03 6.96 
with c.c. Age > =70, Pneumo- 
nia. C.O.P.D 



13A Pulmonary Embolism 



13B Neoplasm with Bronchoscopy 



536 11.29 7.75 .69 



807 12.83 7.09 .55 18B Pulmonary Embolism without c.c 372 11.64 6.16 .53 



16A Pneumothorax age <=70 w/o 349 5.42 3.39 .63 

c.c 

17A Pneumothorax age > =70 and/or 167 9.74 6.60 .68 



19B Pulmonary Embolism, and/or c.c 434 13.86 7.66 .55 



16B Spontaneous Pneumothorax 



351 6.59 5.00 .76 



14A Respiratory Signs and Symptoms 798 4.16 3.15 .76 

age <70 w/o c.c 

15A Respiratory Signs and Symptoms 549 6.44 5.54 .86 

age > =70 and/or c.c 

9A Respiratory Infections and Infla- 640 11.78 8.79 .75 

mabons 

18A Pleural Effusion and Pulmonary 196 7.18 6.29 .88 

Edema age < =70 w/o c.c 

19A Pleural Effusion and Pulmonary 797 10.34 7.88 .76 

Edema age >=70 and/or c.c 

20A Interstitial Lung Disease age 198 5.82 4.51 .77 
<=70 w/o c.c 

21 A Interstitial Lung Disease age 277 9.84 7.31 .74 

> = 70 and/or c.c 

22A Other Respiratory Diagnoses age 593 4.85 4.25 .88 
<=70 w/o c.c 

23A Other Respiratory Diagnoses age 800 8.55 6.30 .74 

> =70 and/or c.c 



17B Painful Respiration 



20B Other Respiratory Diagnoses 



946 4.60 3.46 .75 



4371 8 13 6.93 .85 



10C Without Respirator. Severe Pul- 153 5.53 4.67 .84 

monary. Age < = 1 5 
13C Without Respirator, Age 16-69 1380 8.69 6.71 .77 

without c.c, Severe Pulmonary 
16C Without Respirator. Age 16-69. 3011 11.50 8.24 .72 

with c.c. age > = 70. Severe 

Pulmonary 



1 7C Respirator 



879 10.93 8.43 .77 



Percent Explained 
Variation = 18.97 



Percent Explained 
Variation = 17.96 



Percent Explained Variation 
= 19.82 



100 



Surgical partitioning 

Operating room procedures related to respiratory 
diseases are given in Figure 4.3. 
All three schemes were partitioned into two groups: 

Scheme A: Major chest procedures 
Other procedures 

Scheme B: Resection procedures 
Other procedures 

Scheme C: Invasive, radical procedures 
Other procedures 

The specific surgical codes assigned to the major 
chest group by Team A, to the resection group by 
Team B, and to the invasive, radical group by Team 
C are outlined in Figure 4.3 to facilitate the 
identification of common codes across schemes. 

Schemes A and C are similar in that their surgical 
groups appear to represent major and minor 
procedures. On the other hand, Scheme B isolates 
lobectomies (partial or complete) from all other 
procedures. Unlike Teams A and C, therefore, Team 
B chose not to include with lobectomies: other major 
lung procedures (such as lung transplants, lung repair) 
and related thymus, mediastinal, diaphragmatic, 
pericardial, major vessel, and major thoracic 
surgeries. 

In summary, at the first stage of the surgical 
partitioning, all teams agreed on the grouping of the 4 
resection procedures. There is considerably more 
agreement between Teams A and C whose major 
chest and invasive/radical groups contain a similar set 
of codes. In terms of further partitioning, however, 
Team C created 3 and 4 diagnostic groups, 
respectively, within the major and minor surgical 
splits, while Team A chose only to subset the minor 
surgical group into patients with versus without 
complications or comorbidities. Team B considered its 
two surgical groups as terminal and did no further 
partitioning. 



Medical partitioning 

Teams A and B initially partitioned medical patients 
into 1 1 and 8, respectively, diagnostic subgroups. 
These were further divided into terminal groups or 
DRGs based on age and comorbidities/complications. 
On the other hand, Team C chose first to isolate 
patients on a respirator. (In this sample 879 patients 
were on a respirator.) Those not on a respirator were 
divided initially into groups based on age and 
comorbidities/complications and then into terminal 
groups based on principal diagnosis. Thus, with the 
exception of Team C's respirator group, DRGs in all 
three schemes are defined on the basis of principal 
diagnosis, age, and the presence of comorbidities or 
complications. 

Of particular interest in light of the clinical 
coherence criterion, is how each team grouped 
together principal diagnoses. It appears from the three 
diagrams in Figure 4.2 that all three teams agreed to 
form separate groups for bronchitis and asthma and 
pneumonia. Teams A and B further agreed to form 
separate groups for chronic obstructive pulmonary 
disease (C.O.P.D.), neoplasms, pulmonary embolism, 
pneumothorax, and selected signs and symptoms. 
Agreement among the teams with respect to the 
composition of the diagnostic groups is discussed 
below. 

Bronchitis and asthma. Figure 4.4 contains codes 
considered by any one of the schemes to be part of its 
bronchitis/asthma group. (Note from the Reference 
Lists in Appendix IV that Team C modified this 
group depending on the age range. Figure 4.4 
includes all codes ever assigned by Team C to the 
bronchitis/asthma group, regardless of age.) It is 
observed that Teams A and B include in this group 
conditions of the bronchus and trachea and asthma. 
The major difference between the two teams is that 
Team A also chose to include whooping cough. On 
the other hand, Team C in addition to asthma and 
bronchitis, included some chronic conditions as well 
as selected signs and symptoms, injuries, pleurisy, 
viral pneumonia, and pneumothorax. 



101 



Figure 4-3 



Operating room procedure codes included in the major chest surgical group by Scheme A, the resection 
surgical group by Scheme B, and the invasive, radical surgical group by Scheme C 




3174 
3175 
3179 
3191 
3192 
3199 
3199 



3341 
3342 



3422 
342a 
13427 
3428 
3429 



2ZZ : 


1-' v I 








3229 
323 
32* 
325 


■ 


DESTROY LCC LUNC L£S NEC 
SECHENTAL RESECTION OF LUNC 
LOBECTOMY OF- LUNC 
COMPLETE PNE'.'MCNECGMY 


V 




J2b 
329 




::ssec t-.orac struct 
other excision of lunc 







3T5 - 

321 



Codes Included 

in Schcmr: 
ABC 



THYMUS BIOPSY 
THYMECTOMY NOS 
PART EXCISION OF THYMUS 
TOTAL EXCISION OF THYMUS 
THYMUS FIELD EXPLORATION 
INCISION OF THYMUS 
REPAIR CF THYMUS 
THYMUS TRANSPLANTATION 
THYML'S OPERATION NEC 



200. 


L-R^N.; CYST MAR5UPIALIZ 




300" 


:E3 t =VCT .•»>« _£= NEC 




1301 












2022 


VOCAL COROuCTCMY 




1*029 


other rart laryngectomy 




303 


COMPLETE LARYNGECTOMY 




l304 


RADICAi. LARYNGECTOMY 




3121 


MEDIASTINAL TRACHEOSTOMY 




13:29 


OTHgo PPPM TRachECSTCM" 


\ 


313 


INC IS LAR-N* TRACHEA NEC 




31S 


LOCAL DESTRUC LARYNX LE5 




3161 


SUTURE OF LARYNGEAL LAC 




3162 


LARYNCEAL FISTULA CLOS 




3163 


L^RYNCOSTOMY REVISION 




3164 


LARYNGEAL FX REPAIR 




3169 


OTHER LARYNGEAL REPAIR 




3171 


SUTURE OF TRACHEAL LACER 


1 


3172 


CLOSURE OF TRACHEOSTOMY 




3; ?3 


"aC-Ea RISTVLA COS ne; v 





REVISION CF TRACHEOSTOMY 
TRACHEAL RECONSTRUCTION 
OTHER TRACHEAL REPAIR 
LAHYNCEAL NERV DIVISION 
L'SIS TRaCh/LARYNX ADHE3 
OTH LARYNGEAL OPERATION 
CHER TRACHEAL OPERATION 



LOCAL DESTRU 
OTHER SRC'CH 



I At 



2RC.NC LES 
EXCISION 



3325 




OTHER jRCNCHIAL BIOPSY 




3327 




OTHER LUNG BIOPSY 




332Q 




BRONCHIAL DX PROC NEC 




3229 




LUNG DIAGNOSTIC PROC NEC 




3334 




THORACOPLASTY 




2*1 J-r 




subc collars z~ lumc nec 





BRONCHIAL LACER AT SUTURE 
BRONCHIAL F.ST'JLA CLO? 



CRO;:ch;al =;rair n;c 



3349 
335 


sXSN] LUNC R £F a ; R NEC 
SNSS LUNG TRANSPLANT 




3->92 ESCriCHIAL L I CAT I CM 

3393 PUNCTURE OF LUNC 

3398 BRONCHIAL OPERATION NEC 




3399 
3402 
3403 
341 


w 


LUNC OPERATION NEC 
EXPLORATORY THORACOTOMY 
REOPEN THORACOTOMY 

INCISION CF MEDIASTINUM \ 





MEDIASTINOSCOPY 

OTHER me; ;a-;t!nal BIOPSY 



DX PROCEDURE THORAX NEC 
DX PROC MEDIASTINUM NEC 



*Connon 



TM6 

-nrr 

3*59 



5CAR IF I :at;cn CF PLEUR* 

; r t ::av:m - r v.^z 



3481 
3482 


i 


txc:=£ DIAfhSAON LES'CN 
SUTURE DIAPHRAGM LACER AT 


1 




3483 




CLOSE DIAPHRAGM FISTULA 
OTHER. DIAFHRPK.M. REPfilR. 


• 1 1 

v 




3^85 










3-5 = 











rrr 




ThOFaCIC OPERATION NEC 
PERICARDIOTOMY 
PERICARDIAL BIOPSY 
PSRICARCIECCMY 
OPN CHEST CARDIAC MASSAC 
THORACIC VESSEL INC NEC 
THORACIC END* RTEREC T OMY 
THOR VESSEL RESECT/ANT 
THOR VES RESECT U REPLAC 
THOR AC VAR v LIC-STRIP 
THORACIC VESSEL EXCIS 



P'.ICAT 



3999 

4011 
4019 
4021 

[?S5 



4024 

4029 
403 

4*«2 



4062 
4063 
4064 

4069 
5380 



5381 
5382 
SOT - 



7701 

7711 

7721 

7731 

7741 

7761 

7771 

7791 

7791 

7801 

7831 

7841 

7851 

7861 

7871 

7351 

7891 

9227 

7811 



-Er-CRHHA 



CONTROL NCS 



vASCLLAiS jQZ< "jr-VONS' 

VESSEL OPERATION NEC 
LYMPHATIC STRUCT BIOPSY 
LYMPHATIC D I AG PROC NEC 
EXCI S DEEP CERVICAL NCOE 



Ex: 



:se [NT 



I2SE 



"Ex:i=S axIJ^aSY 

EXCISE INCUINAL NODE 
SIMPL EXC LYMPH STRUC NEC 
REGIONAL LYMPH NODE EXC 



;hcrac io;T cannula! Ion 
THORACIC DUCT FISTULIZ 
CLOSE THORACIC DUCT FIZ 
LICATE THORACIC DUCT 
Thhq AC I C ruCTOP NEC 



ThCR RER-OIaPh h£Rn NCS 
DIaPhsaGMATIC PLICATION 
PAB AS' ERN hernia RE= a;b 

= A;R-3;AP-,fl -£;vjrA~ 



Codes Incljoed 
in Sctieae : 





Codes : 




A 


i c 


343 




DE3TRUCT MED I AST I N LES 


y 




•21S 








y 



3S85 




CCOLuOE rhCBACIC VES 


3954 




PE-ENTOv 0PE9AT7CN 



a"TcT 



CHEST CAGE ScOUeSTREC 
OTHER CHEST CACE INCIS 
CHEST CACE UEDC OSTEOTOM 
CHEST CAGE BONE DIV NEC 
CHEST CAGE BONE BIOPSY 
EXC CHEST CACE BO.'.E LES 
EX CHEST CACE BONE-GFT 
OTH CHEST CAGE OSTEOTOMY 
TOT CHEST CAGE OSTEOTOMY 
BONE CRAFT TO CHEST CAC- 
BCNE LNCTH CHNCE-THCDAX 
OTHER CHEST CAGE REPAIR 
INT FIXATION-CHEST CACE 
REMOV INT FIX-CHEST CACE 
OSTEOCLASIS-CHEST CACE 
OTH OX PROC 2D -CHEST CAGE 
OTH BC.NE OPS-CHEST CACE 
RAOIOACTIVE ELEM IMPLANT 
PERIOSTEAL STURE 



• Coracn codes for: Schemes A.B.C 



Schexaes A,C 



102 



a> 

3 



£1 
"D 

E 



V) 

a 

o 
i_ 

a> 
o 

(0 

o 
c 
o> 

(0 

TJ 

(0 

E 

(0 

.« z, 

1 = 
§■ 

a> to 

£ I 
o - 



a> 



C 

o 

>. 
c 
<a 



■o 
a> 
■o 

3 

O 

c 

(0 

a> 

T3 

o 

u 

(0 

"!o 
o 
c 

O) 

n 
Q 



"8 i 

u o 
c — 

i— i U i 



->1 




u 

V) 





103 



419-177 - 



84 -- 8 



Pneumonia. Figure 4.5 contains codes considered by 
any one of the schemes to be part of its pneumonia 
group. As with bronchitis and asthma, Teams A and 
B generally agree in terms of the diagnoses included 
in this group. On the other hand, Team C includes 
with pneumonia: benign and secondary malignant 
neoplasms of the respiratory system, selected chronic 
lung diseases, injuries, and C.O.P.D. (for ages over 16 
years). 

C.O.P.D. Both Teams A and B isolated C.O.P.D. as 
a separate diagnostic group with a similar set of 
codes. The major difference is that Team A included 
bronchiectasis in this group, while Team B included it 
with the other respiratory category. 

Neoplasms. Malignant, secondary malignant, and 
benign neoplasms were combined into a separate 
group by Teams A and B. The set of diagnosis codes 
included in this group is almost identical (Team A 
included abnormal PAP smear, other site, while Team 
B did not) under both schemes. On the other hand, it 
was noted above that Team C assigns some secondary 
malignant and some benign neoplasms to the 
pneumonia group. The remaining neoplasm diagnoses 
are assigned by Team C to its severe pulmonary 
group. 

Pneumothorax. Teams A and B also created a 
separate pneumothorax diagnostic group. Team A's 
group consisted only of spontaneous pneumothorax. 
Team C grouped spontaneous pneumothorax with the 
bronchitis and asthma group, and traumatic 
pneumothorax with the severe pulmonary group. 

Pulmonary embolism. A separate pulmonary 
embolism group was constructed by Teams A and B. 
Team A included both pulmonary embolism (4151) 
and fat embolism (9581), while Team B included 
pulmonary embolism and air embolism (9580). Of the 
three embolismic diagnoses, pulmonary embolism is 
by far the most frequent diagnosis (826 discharges in 
the sample data base versus 1 discharge for fat 
embolism and no discharges for air embolism), so that 
the two schemes essentially group together the same 
patients. Team C assigns these diagnoses to its severe 
pulmonary group. 

Signs and symptoms for painful respiration. Both 
Teams A and B created a separate symptom group, 
referred to as signs and symptoms in Scheme A, and 
painful respiration in Scheme B. The only diagnosis 
the symptom groups have in common is painful 
respiration (78652), which is also the most frequent in 
the sample data base. The remainder of Scheme A's 
signs and symptoms were assigned by Team B to its 
other respiratory disease group. Pleurisy w/o effusion 
or TB, which was considered part of Team B's 
painful respiration group, was assigned to the 
pneumonia group by Team A. It was noted earlier 
that Team C placed pleurisy and painful respiration in 
the bronchitis asthma group. 

Respiratory infections and inflammations, interstitial 
lung diseases, pleural effusion, and pulmonary edema. 
Team A chose to isolate more complex respiratory 



infections, interstitial lung diseases, and pleural 
effusion and pulmonary edema by constructing 3 
additional diagnosis groups. These diagnoses were 
generally assigned to the other respiratory diseases 
group by Team B and to the severe pulmonary group 
by Team C. 

Analysis of agreement 

A method for measuring agreement between two 
hospital classification schemes has been presented in 
Klastorin (Klastorin, 1978) and Klastorin and Watts 
(Klastorin, et al., 1980). It was applied in this project 
to assess the extent of agreement between (1) Schemes 
A and B, (2) Schemes A and C, and (3) Schemes B 
and C. The method is described in more detail in the 
Reference Listing in Appendix IV. The application of 
the context of this substudy is summarized briefly and 
a report of the findings follows. 

Klastorin 's Kappa. The objective of the analysis is to 
determine the extent to which any two of the 
classification schemes "agree" in the partitioning of 
patient records from the major diagnostic category 
(MDC), Diseases and Disorders of the Respiratory 
System. Assume for the purpose of illustration that 
the schemes of interest are A and B. 

All pairs of patient records in the MDC are formed, 
and each pair is then examined to determine which 
one of the following statements is true: 

• The members of the pair are assigned to the same 
DRG by both schemes. 

• The members of the pair are assigned to the same 
DRG by Scheme A but to different DRGs by 
Scheme B. 

• The members of the pair are assigned to the same 
DRG by Scheme B but to different DRGs by 
Scheme A. 

• The members of the pair are assigned to different 
DRGs by both schemes. 

Compute the total number of pairs for which 
statement 1 is true, for which statement 2 is true, etc. 
and summarize the results in a table of the following 
form: 



Scheme A 







Assignment to same 








DRG: 






Yes 


No 


Scheme B 








Assigned to 


Yes 


n 


n n 


same DRG: 


No 


n 


n n 






n. 


n. n. . 



104 



UJ 



oj 

SO) < 
Q £ 
2 £ 

o o 
UJ Z a. 

V|U, ^ 0) 
J It. U. In 
y y O 

tn j o 
- < < u 

uyyJ 
' -J j ? 
a. a. a. 



r cd z 
— z f 



m — 

o _J 

X O 

UJ CE 
Q (J 

m r 

o 

£ CC 

UJ < 

Z _i 

c 
r uj 



o 

U) _J 

> 5 _i 

j o. < 
< 

O £ 

o. — a. 



U 0) 

UJ o 
Z Z 

> > 

z z < 

H- — 

< * 5 

a. a. 5 

□ a £ 

s rs - 

c a ui 

55f 

UJ UJ 
Z Z u 
a. a. — 

_i _J < 

o o c 

UI UJ 3 

> > UJ 
-I -J Z 

< < K 



m 

— to < 
o - r 

a uj 

O CO 

5i-i 
r 

10 Z UJ 

tn _i 
ox 
ce _i — 

UOh 
_l > - 
O Z H 
03 — 05 
X 
O UJ 
0) Z >- 

> 3 z 

UJ _J - 



< 

< - 

r _i 

uj =. cn 

as z c 

> o. Z 
1 ° ^ 

CL Z < 
Z ~ Z 

UJ CD UJ 

s a 

> UJ UJ 
C UJ 

a § 

*~ > 5 

< cs 3 
ui < _i 
z z , 
UJ o u 
irt 

Z _l 3 
O 3 <-> 



3 
•J 

u 

u — o 

UJ o »- z 

Z Z 05 3 

3 > _J 

uj u. 

< O JO 
UJ — < 

U3 O 0) 

a < z cd 

§ui UJ 
o z 

Z UJ Z UJ 
3 Z O O 
J t y < 



U CD 

uj g 

OZZ 

m >• > 

uj <j c r 

3UlOO 

z - z Z 
z< < 

> u 

JZ>> 

rcoa 
a m »- 
z < < 
< z e cc 
iu "" — 

OOll 
Z 2 05 UJ 
3 O UJ UJ 



Uj Z 
Z o 

I< 

< a 
5 

1° 

C CO 

UI UJ 



< 
•» r 



- 2 



— < 

e 



UJ 

uj a 

3 UJ 

_i r 
~> c 
i «j 

05 U 

a 

— uj 

CC O 

z 

ce 

3 0J 
C a 



z z 

u. u. 

a. a. 

o o 

— Dili 



03 

o - 

Z CC 

a u> 
- z 

CC O 



Z CD 

UJ o 

Z CL _J 
U, O O 

C I I 
□ UJ z 
i a 3 
0J ~ z 
exc 

— UJ 

CE UJ »- 

UJ CD 
O CC 

3 Z u. 

»- a 



< 

— CC 

x 3 



UJ UJ UI UJ UJ 

e cc cc ce cc 

3 3 3 3 3 



1 y 

a. < 

UJ cc 

< u. 



33-133333 
»-^3*-^-*-*->- 



U Z 
< 

CC x 



u u <_> u o 

< < < < < 

CC CE CC CE CE 

u. u. u. u. u, 



Hi 

z z < 

I (t * 

ui ui 

03 03 U. 
^ 2 « 

cog 
uj *- 2 

CC < 5 
3 u 3 

° * 

CC — 2; 
U. O O 










j= 

u 


_J K 


t/J 


0. 03 




Z UJ 




z z 




1 




CMC A 
NJUfl 


Li 


< — 




CE 


U 




z 




Q — 




§ U. 




a u. 




3 UJ 




z uj 


< 


UI K- 


tn 


0. < 


a -i 


i 



cd o- _ o — rKOJO- — rKCD — n«ri*-a3CD*r>-o-oaJi>n-or) oooo----« nrso - o 

— •0<4-0'04)KNr > >CDCDCDCDCDvCDmCDOCDCD'«'4— 0>-r>.^r»r».*.rs.r»r>» f^o-» * cp 

- - -- -- -- -- -- --l^-^iJi^T^rjnco a-oooooooo onj-^o 

(>•>•> nr>r>nnnnr>»inr>r>r>KNiN.i>tNi>rvKi > »N r^cDCDCDCDCDCDCDCO CD cd cd cd o- 




o-mnnntnuO'-n-flioO' _ 

-vr^r^r^oi<\'Ojr\icvr\i«r'aoooo m 

j.^O-O- — — — — - -0!a]CCD03~ 

«^H-r*f>imoiClOi»:"rT»"r* v 



I— i n in -o 

D l«r <r <r t «r t 

CO !CD 3 — C ~ ~ 

»[<i <r c » >r «r 

__] 



n o a o - n< n » o; 

a a aj'o- o-o-o-?ooooooooooo 



The proportion of agreement, the proportion of 
agreement corrected for that expected by chance 
alone (observed minus expected proportion of 
agreement) and a kappa-type index of agreement may 
then be calculated from the table in the manner 
described in the Reference List in Appendix XIII. 
The statistical significance of kappa (k) is tested using 
a z statistic of the form: 

z = k/ variance (k) 

Which is distributed N(0,1). If z>2.58 it can be 
concluded that the observed degree of agreement is 
significant at the .01 level. In addition to using 
Klastorin's Kappa statistic, an alternative approach 
was used. This approach, referred to as the "enhanced 
matching statistic", was developed by Ament, et al., 
of the Commission on Hospital and Professional 
Activities (CPHA). CPHA considers there are 
potential problems with the Klastorin kappa statistic 
taking on values that are not particularly meaningful 
when the group sizes (or DRGs sizes) of one system 
of classification are small compared to the other. 

Findings 

Cross classification of patients by schemes 

Because agreement is defined and measured in 
terms of the schemes grouping together the same sets 
of patients, it is instructive initially to examine the 
cross tabulation of patients by each pair of schemes. 
Tables 4.2, 4.3, and 4.4, respectively, present the 
number of patients cross classified by Schemes A and 



B, Schemes A and C, and Schemes B and C. The 
number of patients assigned to the DRG 
corresponding to row i by the first scheme, and to the 
DRG corresponding to column j by the second 
scheme, can be found in the (i,j) 'th cell of each table. 
For example, 2577 patients were assigned to DRG 4A 
by Scheme A, and to DRG 3B by Scheme B (see 
Table 4.2). A blank cell indicates zero patients. No 
patients, for example, in DRG 2A were assigned to 
DRG IB by Scheme B. In fact, all patients assigned 
to DRG 2A by Scheme A were assigned to DRG 2B 
by Scheme B. 

The particular pattern of the numbers in these cross 
tabulations indicates the extent of agreement between 
the corresponding schemes. Perfect agreement is 
achieved when both schemes have the same number 
of DRGs and there is a one-to-one mapping of DRGs 
between the schemes. That is, each DRG in one 
scheme contains only those patients in a parallel DRG 
from the other scheme. When there is perfect 
agreement between two schemes, the corresponding 
cross tabulations would have only one number — non- 
empty cell — appearing in each row and column. The 
extent to which the schemes disagree is reflected in 
the extent to which the table deviates from this 
pattern. That is, a table with a large number of non- 
empty cells in any row or column reflects a high level 
of disagreement, for it indicates that patients grouped 
together in one scheme were dispersed among several 
DRGs (that is, not grouped together) in the other 
scheme. 



106 



Table 4-2 

Number of discharges cross classified by Scheme A and Scheme B 

Scheme B 



DRG 
No. 



1B 2B 3B 



4B 



5B 



6B 



7B 



8B 10B 9B 11B 14B 15B 12B 13B 18B 19B 17B 16B 20B 



554 540 
271 
206 



2577 

67 1407 1310 
5 402 



1263 



1537 1028 691 



184 
16 



699 381 1340 
14 25 8 66 



1915 



142 
69 



2056 



1877 536 



372 434 



496 
238 



244 
107 



24 
25 
34 



511 
69 
67 
2 
1 

302 
311 
105 
59 
196 
797 
198 
277 
593 
800 



Based on these remarks, it is evident from Tables 
4.2-4.4 that Teams A and B are in the closest 
agreement since Table 4.2 most closely follows the 
one-number-per-row-and-column pattern. For the 
most part, it appears from Table 4.2 that only one or 
two cells dominate each row and column. This 
indicates that patients from one DRG in Scheme A 
tend to be grouped into only one or two DRGs in 
Scheme B, and vice versa. In fact, the following sets 
of DRGs are virtually identical: 

DRG 4A < > DRG 3B 

DRG 10A < > DRG 14B 

DRG 11A < > DRG 15B 

The major area of disagreement is traced to patients 
in Scheme B's "Other Respiratory Disease" group 



(DRG 20B). These patients were distributed across 18 
of Scheme A's DRGs. 

On the other hand, Tables 4.3 and 4.4 indicate a 
somewhat lower level of agreement between Schemes 
A and C and Schemes B and C. In both tables, it is 
observed that patients from a DRG in one scheme 
tend to be distributed across 3 or more DRGs in the 
other. However, in many instances patients from a 
DRG in one scheme are grouped predominantly into 
only one or two DRGs in the other scheme, 
indicating that the schemes are still reaching a 
reasonably high level of agreement. For example, the 
following sets of DRGs are almost identical: 

DRG 4A < > DRG 8C 

DRG 3B < > DRG 8C 

DRG 7B < > DRG 9C 



107 



DRC 
No. 



Table 4-3 

Number of discharges cross classified by Scheme A and Scheme C 

Scheme C 



sc 


6C 


7C 


re 


2C 


3C 


4C 


173 


458 


104 


34 


72 


178 


75 


4 


5 


11 


20 


77 


139 


15 


4 


5 


12 


4 


30 


136 


15 



8C 


11C 


14C 


9C 


12C 


15C 


10C 


13C 


16C 


17C 


2576 












18 






8 


67 


2348 


401 














1 


5 




1636 






1 








67 


4 


229 




1565 


1536 




23 


91 










142 


175 




2620 


7^ 




151 


78 


2 


5 


1 








43 


193 


375 


21 


10 


155 


41 


1 


1144 


614 


15 


2 




2 


2 




150 


2 




1665 


6 




3 


295 




1 


1 




3 


7 


6 


621 


1727 


49 














2 


285 


510 


10 


58 


740 


















6 




539 














4 


3 


252 










3 


91 






1 




109 








1 




53 


3 










157 




8 


8 




23 








2 




489 


1 




19 


286 


5 


91 




22 


61 




4 


15 






1 




132 


2 




81 


2 




45 


14 


56 


269 




3 


183 




8 


74 






13 




346 


3 




286 


6 




128 


18 



1A 
2A 
3A 
4A 
5A 
6A 
7A 
8A 
9A 
< 10A 
| 11A 
a> 12A 
o 13A 
W 14A 
15A 
16A 
17A 
18A 
19A 
20A 
21A 
22A 
23A 



Table 4-4 

Number of discharges cross classified by Scheme B and Scheme C 

Scheme C 



DRG 
No. 



5C 6C 7C 1C 2C 3C 4C 8C 11C 14C 9C 12C 15C 10C 13C 16C 17C 



1B 


99 


375 


80 






















2B 


82 


93 


47 


58 179 453 105 




















3B 








2641 


















8 


4B 










1407 


382 














20 


5B 










915 


394 














1 


6B 












1216 






1 








46 


7B 














1740 






44 






3 


m 8B 










69 






917 






56 






« 10B 










39 


22 




619 


642 




46 


45 


2 


§ 9B 












15 






333 






33 


8 


■g 11B 












40 






1645 






147 


74 


w 14B 








11 


120 


29 




1133 


612 


15 


2 




2 


15B 








2 




108 


1 




1650 


6 




3 


291 


12B 
















1 


4 


6 


452 


1374 


40 


13B 
















2 


3 




169 


353 


9 


18B 




















2 


295 


85 




19B 
























424 


10 


17B 








8 


613 


302 








1 


16 


4 


2 


16B 








4 


241 


105 














1 


20B 








143 


686 


885 


34 


412 


873 


79 


354 


543 


362 



108 



It appears that the major areas of disagreement 
concern patients in DRG 20B (Other Diseases of the 
Respiratory System) and DRG 17C (Respirator). 

In summary, from the cross tabulations it appears 
that the schemes tend to group together similar sets of 
patients, and that agreement is greatest for Schemes A 
and B. However, it should be noted that some DRGs 
are dominated by one or two diagnoses or 
procedures. A certain level of agreement is therefore 
expected because all patients with that diagnosis or 
procedures who meet the other criteria (such as age) 
of a DRG are automatically grouped together. 

Measuring agreement 

Klastorin's approach was applied to the data in 
Tables 4.2-4.4 to obtain a measure of agreement 
between Schemes (1) A and B, (2) A and C, and (3) B 
and C. The results, presented in Table 4.5, indicates 
that the proportion of agreement is high among the 
schemes, and ranges from .94 for A versus B to .88 
for B versus C. (Note: 1.00 is perfect agreement.) 
Since the expected proportion of agreement is also 
large, the corrected proportion of agreement is low; 
that is, the schemes achieved little agreement beyond 
that expected by chance alone. However, the Z 
statistic for all comparisons is at least 1000, indicating 
that the index of agreement is statistically significant 
(p<.0001). Therefore it can be concluded that there is 
agreement among the schemes in the partitioning of 
patient records from Diseases and Disorders of the 
Respiratory System. 

Table 4.5 
Summary of agreement measures 



Comparison 





A versus B 


A versus C 


B versus C 


Proportion of 








agreement 


.94 


.90 


.88 


Expected 








proportion of 








agreement 


.86 


.82 


.82 


Corrected 








proportion of 








agreement 


.08 


.08 


.06 


Kappa (index of 








agreement) 


.58 


.43 


.33 


Variance of 








Kappa 


6.9 X E-8 


7.9 X E-8 


9.6 X E-8 


Z statistic 


2204.32 


1532.45 


1065.46 



CPHA's enhanced matching statistic 

CPHA has developed an alternative matching 
statistic, L, that is considered more interpretable than 
Klastorin's Kappa when the group sizes, (that is DRG 
sizes) of one system of classification are small 
compared to the other Ament, et al.). This statistic 
was also computed, and the results are presented for 
each comparison: 

A versus B A versus C B versus C 
.591 .579 .455 

Given the same variances as reported in Table 4.5,* 
the corresponding Z-statistics would all exceed 1,000. 
(The standard error of Klastorin's Kappa is used to 
test for the significance of L.) The results are 
therefore consistent with those found with Klastorin's 
Kappa. 

Implications for inter-institutional comparisons 

The major applications of the DRGs have been in 
the area of inter-institutional comparisons, such as 
utilization review and case-mix reimbursement (Fetter, 
et al., 1980). Such applications generally involve 
comparing one hospital's cost or length of stay to an 
average based on a group of institutions to which the 
hospital belongs. DRGs are used to control for 
differences in case-mix, that is differences in the 
distribution of discharges by type of case. Depending 
on the setting, the hospital may be rewarded or 
penalized in some way for its performance based on 
these comparisons. 

A concern in these comparisons is that different 
systems of classification may yield different findings. 
For example, if a hospital has a relatively high 
proportion of its cases with comorbidities, then it may 
compare unfavorably in terms of longer lengths of 
stay or higher costs if the classification scheme used 
to adjust for case-mix does not control for 
comorbidities. Although the three schemes achieved a 
statistically significant level of agreement, it is 
possible that some differences exist among the 
schemes for selected types of patients which are seen 
more often in one type of hospital than another. If 
such patients are unusually high or low resource 
users, then comparisons involving these institutions 
may produce different results, depending on the 
classification scheme used to define case types. 



* A minor teaching hospital has at least one approved residency 
among the following four specialties: internal medicine, obstetrics/ 
gynecology, pediatrics, surgery. A major teaching hospital has 
approved residencies in at least three of those four specialties. A 
non-teaching hospital does not have approved residencies in any of 
those four specialties. 



109 



It was therefore of interest to examine the impact 
of each scheme on inter-institutional comparisons for 
selected types of hospitals. To this end, 10 types of 
hospitals were defined based on geographic location 
(census region), bedsize, and teaching status: 

Census Region 

Northeast 

North Central 

South 

West 

Bedsize 

Small (less than 100 beds) 
Medium (100-399 beds) 
Large (over 400 beds) 

Teaching Status * 
Non-Teaching 
Minor Teaching 
Major Teaching 

Each type of hospital was then compared to all 
hospitals on the basis of length of stay, controlling for 
case-mix with Scheme A, Scheme B, and Scheme C. 

The results for each type of hospital are given in 
Table 4.7 through 4.16. The analysis is purely 
descriptive and involves computing for each type of 
hospital and each classification scheme (A, B and C): 
the number of cases in the DRG (NUM CASES), the 
proportion of cases in the DRG (CASEMIX 
PRPRTN.), the average length of stay in the DRG 
for that type of hospital, the average length of stay in 
the DRG for all hospitals (ALL HOSP), and the 
difference in average length of stay between the 
hospital type and all hospitals (DIFF). Finally, an 
"expected difference in average length of stay per 
case" is generated which is the average lenght of stay 
(LOS) in days per case above or below all hospitals. 
It is computed in the following manner: 

expected difference = (DIFF)*(CASEMIX PRPRTN.) 

in LOS per case i=l 

where i indexes DRG number, and n is the total 
number of DRG's in the scheme. For example, using 



* A minor teaching hospital has at least one approved residency 
among the following four specialties: internal medicine, obstetrics/ 
gynecology, pediatrics, surgery. A major teaching hospital has 
approved residencies in at least three of those four specialties. A 
non-teaching hospital does not have approved residencies in any of 
those four specialties. 



Scheme A to adjust for case-mix, northeastern 
hospitals have patients that stay on the average .76 
days per case longer than all hospitals (Table 4.7) 
while southern hospitals have patients that stay on the 
average .26 days per case shorter (Table 4.9). 

Tables 4.6 summarizes the expected differences 
from Tables 4.7 through 4.16. The important 
observation to make from this table is that the 
findings are consistent among schemes for all hospital 
types. For example, regardless of the scheme used to 
adjust for case-mix, patients in northeastern and north 
central hospitals stay on the average approximately .8 
and .4 days per case, respectively, longer than all 
patients while those in southern and western hospitals 
stay on the average approximately .2 and 1.3 days 
shorter. In conclusion, there is no evidence that these 
ten types of hospitals would compare more or less 
favorably under one of these three systems of 
classification than another. 

Table 4.6 

Expected difference in length of stay per case by 
type of hospital and classification scheme 

Scheme Scheme Scheme 
ABC 



Census region: 



Northeast 


0.76 


0.79 


0.75 


North Central 


.39 


.45 


.42 


South 


-.26 


-.24 


-.19 


West 


-1.28 


-1.31 


-1.36 


Teaching status: 








Nonteaching 


-.33 


-.36 


-.33 


Minor teaching 


.23 


.30 


.25 


Major teaching 


.91 


.94 


.87 


Bed size: 








Small (<100) 


-1,21 


-1.25 


-1.20 


Medium (100-399) 


-.04 


-.03 


-.03 


Large (400 + ) 


.51 


.52 


.50 



110 



Table 4.7 

Number of cases, case-mix proportion, average length of stay for Northeast hospitals, average length 
of stay for all hospitals, and the difference in average length of stay between Northeast hospitals and 

all hospitals, by DRG and classification scheme 1 



Scheme A Scheme B Scheme C 



DRG 


No. 


Case- 


Average length of stay 


ORG 


No. 


Case- 


Average length of stay 


DRG 


No. 


Case- 


Average length of stay 




















mix 
prprtn. 








mix 
Drortn 








mix 
prprtn. 








Num. 


cases 


North- 
east 


All 
hosp. 


Olff. 


Num. 


cases 


North- 
east 


All 
hosp. 


om. 


Num. 


cases 


North- 
east 


All 
hosp. 


Dm. 


1A 


181 


.035 


16.42 


15.36 


1.06 


1B 


74 


.014 


20.36 


16.62 


3.74 


1C 


13 


.002 


8.08 


7.62 


0.46 


2A 


46 


.009 


9.72 


9.90 


-0.18 


2B 


190 


.037 


1.4.39 


13.17 


1.22 


2C 


33 


.006 


9.39 


9.47 


-0.08 


3A 


37 


.007 


17.05 


15.13 


1.92 


3B 


565 


.109 


3.75 


3.66 


0.09 


3C 


89 


.017 


12.96 


13.28 


-0.32 


4A 


548 


.105 


3.81 


3.67 


0.14 


4B 


303 


.058 


5.55 


5.31 


0.24 


4C 


14 


.003 


20.64 


15.70 


4.94 


5A 


474 


.091 


6.19 


5.77 


0.42 


5B 


207 


.040 


7.55 


6.71 


0.84 


5C 


OJ 


.006 


11.24 


13.36 


-2.12 


ft A 
DM 


307 


.059 


9.12 


8.35 


0.77 


6B 


239 


.u**o 


9.77 


9.03 


0.74 


cr* 
OL. 


RR 
DO 


.013 


21.53 


17.43 


4.10 


7A 


636 


.122 


6.37 


5.99 


0.38 


7B 


296 


.057 


5.14 


5.13 


0.01 


7C 


16 


.003 


25.06 


17.50 


7.56 


OA 

OA 


632 


.122 


10.79 


10.13 


0.66 


8B 


221 


.042 


6.94 


6.47 


0.47 


8C 


596 


.115 


3.73 


3.65 


0.08 


OA 


99 


.019 


12.32 


11.78 


0.54 


9B 


82 


.016 


9.00 


9.00 


-0.08 


9C 


298 


.057 


5.14 


5.07 


0.07 


1AA 


31 1 


.060 


8.91 


7.76 


1.15 


10B 


267 


fiKi 

.\JO l 


9.60 


8.77 


0.83 


10C 


OA 


.005 


5.46 


5.53 


-0.07 


1 1 A 


392 


.075 


11.22 


10.00 


1.22 


1 1 B 


308 


075 


11.83 


11.26 


0.57 


1 1C 


R~7R 


.130 


5.82 


5.29 


0.53 


19A 

1 c.t\ 


465 


.089 


11.06 


10.05 


1.0.1 


12B 


340 


065 


10.09 


9.69 


0.40 


12C 


538 


.103 


8.15 


7.19 


0.96 


13A 


1 73 


.UJJ 


15.25 


12.83 


2.42 


13B 




024 


13.70 


11.29 


2.41 


13C 


236 


.045 


9.01 


8.69 


0.32 


14A 


121 


.023 


4.99 


4.16 


0.83 


14B 


300 


.058 


9.02 


7.81 


1.21 


14C 


606 


.117 


8.48 


7.82 


0.66 


15A 


91 


.017 


6.96 


6.44 


0.52 


15B 


374 


.072 


11.29 


10.00 


1.29 


15C 


1196 


.230 


10.83 


10.03 


0.80 


16A 


63 


.012 


5.75 


5.42 


0.33 


16B 


64 


.012 


6.39 


6.59 


-0.20 


16C 


590 


.113 


12.99 


11.50 


1.49 


17A 


23 


.004 


10.43 


9.74 


0.69 


17B 


129 


.025 


5.63 


4.60 


1.03 


17C 


177 


.034 


12.67 


10.93 


1.74 


18A 


46 


.009 


8.83 


7.18 


1.65 


18B 


64 


.012 


13.61 


11.64 


1.97 














19A 


207 


.040 


12.25 


10.34 


1.91 


19B 


109 


.021 


16.22 


13.86 


2.36 














20A 


39 


.007 


5.62 


5.82 


-0.20 


20B 


863 


.166 


9.07 


8.13 


0.94 














21A 


51 


.010 


9.51 


9.84 


-0.33 


























22A 


103 


.020 


5.38 


4.85 


0.53 


























23A 


156 


.030 


9.08 


8.55 


0.53 



























Expected difference in LOS per case: .76. Expected difference in LOS per case: .79. Expected difference in LOS per case: .75. 



'Case-mix Proportion = number of cases in the DRG (NUM CASES) 

total number of cases for northeast hospitals ( = 5201) 
n 

Expected Difference = 2 (DIFF,) * (CASEMIX PRPRTN.,), 
in LOS per case i = 1 

where i indexes DRG number and n = 23, 20, and 17 for Schemes A, B, and C, respectively 



111 



Table 4.8 

Number of cases, case-mix proportion, average length of stay for North Central hospitals, average 
length of stay for all hospitals, and the difference in average length of stay between North Central 
hospitals and all hospitals, by DRG and classification scheme 1 



Scheme A Scheme B Scheme C 



DRG 

num. 


Num. 
cases 


Case- 
mix 
Prprtn. 


Average length of stay 


DRG 
num. 




Case- 
mix 
Prprtn. 


Average length of stay 


DRG 
num. 




Case- 
mix 
Prprtn. 


Average length of stay 


No. 
Cen- 
tral 


All 
hosp. 


Dlff. 


Num. 
cases 


No. 
Cen- 
tral 


All 
hosp. 


Dlff. 


Num. 
cases 


No. 
Cen- 
tral 


All 
hosp. 


Dlff. 


1A 


300 


.032 


16 17 


1 5 36 


81 


1B 


158 


.017 


16 47 


1 6 62 


— 15 


1C 


12 


.001 


13 33 


7 62 


5 71 


2A 


72 


.008 


1 1 08 


9 90 


1 18 


2B 


279 


.030 


1 4 39 


13 17 


1 22 


2C 


45 


.005 


8.93 


9 47 


— 54 


3A 


65 


.007 


14.88 


1 5.1 3 


— 0.25 


3B 


1,071 


.115 


3 95 


3 66 


29 


3C 


133 


.014 


14.62 


13.26 


1.34 


4A 


1,048 


.112 


3.95 


3 67 


0.28 


4B 


649 


.070 


5 74 


5 31 


43 


4C 


29 


.003 


15.72 


15 70 


0.02 


5A 


946 


.101 


6 09 


5 77 


0.32 


5B 


413 


.044 


7 12 


6 71 


41 


5C 


45 


.005 


14.24 


13.36 


0.88 


6A 


570 


.061 


8.79 


8.35 


0.44 


6B 


406 


.043 


9.53 


9.03 


0.50 


6C 


139 


.015 


17.43 


17.43 


0.0 


7A 


1,308 


.140 


6.20 


5.99 


0.21 


7B 


737 


.079 


5.52 


5.13 


0.39 


7C 


34 


.004 


17.35 


17.50 


— 0.15 


8A 


1.035 


.111 


10.49 


10.13 


0.36 


8B 


377 


.040 


6.54 


6.47 


0.07 


8C 


1,140 


.122 


3.95 


3.65 


0.30 


9A 


189 


.020 


1 1.22 


11.78 


— 0.56 


9B 


134 


.014 


10.03 


9.08 


0.95 


9C 


732 


.078 


5.45 


5.07 


0.38 


10A 


642 


.069 


7.94 


7.76 


0.18 


10B 


418 


.045 


8.68 


8.77 


— 0.09 


10C 


57 


.006 


5.19 


5.53 


— 0.34 


11A 


630 


.067 


10.75 


10.00 


0.75 


11B 


619 


.066 


11.87 


11.26 


0.61 


11C 


1,358 


.145 


5.60 


5.29 


0.31 


12A 


805 


.086 


11.07 


10 05 


1 .02 


12B 


651 


.070 


10.86 


9.69 


1.17 


12C 


998 


.107 


7.34 


7.19 


0.15 


13A 


231 


.025 


12.99 


12.83 


0.16 


13B 


153 


.016 


11.90 


11.29 


0.61 


13C 


416 


.045 


8.92 


8.69 


0.23 


14A 


242 


.026 


4.31 


4.16 


0.15 


14B 


633 


.068 


8.00 


7.81 


0.19 


14C 


1,166 


.125 


8.32 


7.82 


0.50 


15A 


181 


.019 


7.32 


6.44 


0.88 


15B 


612 


.066 


10.76 


10.00 


0.76 


15C 


1,795 


.192 


10.49 


10.03 


0.46 


16A 


93 


.010 


5.27 


5.42 


-0.15 


16B 


110 


.012 


6.61 


6.59 


0.02 


16C 


956 


.102 


12.22 


11.50 


0.72 


17A 


58 


.006 


9.29 


9.74 


-0.45 


17B 


338 


.036 


5.04 


4.60 


0.44 


17C 


280 


.030 


12.04 


10.93 


1.11 


18A 


51 


.005 


7.49 


7.18 


0.31 


18B 


118 


.013 


11.74 


11.64 


0.10 














19A 


256 


.027 


10.48 


10.34 


0.14 


19B 


113 


.012 


14.29 


13.86 


0.43 














20A 


53 


.006 


7.60 


5.82 


1.78 


20B 


1.346 


.144 


8.48 


8.13 


0.35 














21A 


89 


.010 


10.96 


9.84 


1.12 


























22A 


196 


.021 


4.59 


4.85 


-0.26 


























23A 


275 


.029 


9.08 


8.55 


0.53 



























Expected difference in LOS per case: .39. Expected difference in LOS per case: .45. Expected difference in LOS per case: .42. 



•Case-mix Proportion = number of cases in the DRG (NUM CASES) 

total number of cases for north central hospitals (=9335) 

n 

Expected Difference = 1 (DIFF,) * (CASEMIX PRPRTN.,), 
in LOS per case i = 1 

where i indexes DRG number and n = 23, 20, and 17 for Schemes A, B, and C, respectively 



112 



Table 4.9 

Number of cases, case-mix proportion, average length of stay for Southern hospitals, average length 
of stay for all hospitals, and the difference in average length of stay between Southern hospitals and 

all hospitals, by DRG and classification scheme 1 



Scheme A Scheme B Scheme C 



DRG 


Num. 


Case- 
mix 
prprtn. 


Average length of stay 


DRG 


Num. 


Case- 
mix 
prprtn. 


Average length of stay 


DRG 


Num. 


Case- 
mix 
prprtn. 


Average length of stay 


num. 


cases 


South 


All 
hosp. 


Dlff. 






South 


All 
hosp. 


Dlff. 






South 


All 
hosp. 


Dlff. 


1A 


399 


.045 


15.62 


15.36 


0.26 


1B 


216 


.024 


16.99 


16.62 


0.37 


1C 


23 


.003 


6.04 


7.62 


-1.58 


2A 


122 


.014 


9.44 


9.90 


-0.46 


2B 


385 


.043 


12.54 


13.17 


-0.63 


2C 


76 


.008 


9.61 


9.47 


0.14 


3A 


80 


.009 


13.91 


15.13 


-1.22 


3B 


682 


.076 


3.56 


3.66 


-0.10 


3C 


172 


.019 


12.60 


13.28 


-0.68 


4A 


680 


.076 


3.57 


3.67 


-0.10 


4B 


558 


.062 


5.27 


5.31 


-0.04 


4C 


38 


.004 


14.55 


15.70 


-1.15 


5A 


929 


.104 


5.74 


5.77 


-0.03 


5B 


453 


.051 


6.56 


6.71 


-0.15 


5C 


63 


.007 


14.76 


13.36 


1.40 


6A 


500 


.056 


8.13 


8.35 


-0.22 


6B 


381 


.043 


8.69 


9.03 


-0.34 


6C 


178 


.020 


17.62 


17.43 


0.19 


7A 


1,102 


.123 


5.86 


5.99 


-0.13 


7B 


584 


.065 


4.83 


5.13 


-0.30 


7C 


51 


.006 


16.53 


17.50 


-0.97 


8A 


929 


.104 


9.87 


10.13 


-0.26 


8B 


322 


.036 


6.57 


6.47 


0.10 


8C 


716 


.080 


3.55 


3.65 


-0.10 


9A 


221 


.025 


12.18 


11.78 


0.40 


9B 


126 


.014 


8.78 


9.08 


-0.30 


9C 


579 


.065 


4.82 


5.07 


-0.25 


10A 


711 


.079 


7.62 


7.76 


-0.14 


10B 


455 


.051 


9.16 


8.77 


0.39 


10C 


53 


.006 


6.13 


5.53 


0.60 


11A 


707 


.079 


9.55 


10.00 


-0.45 


11B 


526 


.059 


10.77 


11.26 


-0.49 


11C 


1,413 


.158 


5.33 


5.29 


0.04 


12A 


761 


.085 


9.39 


10.05 


-0.66 


12B 


592 


.066 


9.20 


9.69 


-0.49 


12C 


1,071 


.122 


7.17 


7.19 


-0.02 


13A 


270 


.030 


11.88 


12.83 


-0.95 


13B 


168 


.019 


10.07 


11.29 


-1.22 


13C 


507 


.057 


9.12 


8.69 


0.43 


14A 


287 


.032 


4.33 


4.16 


0.17 


14B 


678 


.076 


7.65 


7.81 


-0.16 


14C 


1,090 


.122 


7.56 


7.82 


-0.26 


15A 


199 


.022 


5.97 


6.44 


-0.47 


15B 


692 


.077 


9.54 


10.00 


-0.46 


15C 


1,729 


.193 


9.70 


10.03 


-0.33 


16A 


138 


.015 


5.73 


5.42 


0.31 


16B 


128 


.014 


6.88 


6.59 


0.29 


16C 


912 


.102 


10.87 


11.50 


-0.63 


17A 


50 


.006 


0.96 


9.74 


-8.78 


17B 


322 


.036 


4.48 


4.60 


-0.12 


17C 


266 


.030 


10.11 


10.93 


-0.82 


18A 


73 


.008 


6.77 


7.18 


-0.41 


18B 


134 


.015 


11.36 


11.64 


-0.28 














19A 


220 


.025 


9.53 


10.34 


-0.81 


19B 


135 


.015 


12.44 


13.86 


-1.42 














20A 


77 


.009 


5.43 


5.82 


-0.39 


20B 


1,420 


.159 


7.94 


8.13 


-0.19 














21A 


85 


.009 


9.19 


9.84 


-0.65 


























22A 


195 


.022 


5.24 


4.85 


0.39 


























23A 


214 


.024 


8.92 


8.55 


0.37 



























Expected difference in LOS per case: -.26. Expected difference in LOS per case: -.24. Expected difference in LOS per case: -.19. 



1 Case-mix Proportion = number of cases in the DRG (NUM CASES) 

total number of cases for southern hospitals (=8957) 

n 

Expected Difference = 2 (DIFF,) * (CASEMIX PRPRTN.,), 
in LOS per case i = 1 

where i indexes DRG number and n^ 23, 20, and 17 for Schemes A, B, and C, respectively 



113 



Table 4.10 

Number of cases, case-mix proportion, average length of stay for Western hospitals, average length 
of stay for all hospitals, and the difference in average length of stay between western hospitals and 

all hospitals, by DRG and classification scheme 1 



Scheme A Scheme B Scheme C 



DRG 

num. 


Num. 
cases 


Case- 
mix 
prprtn. 


Average length 
Wert hosp. 


ot stav 
Dlff. 


DRG 
num. 


Num. 
cases 


Case- 
mix 
prprtn. 


Average length ot stay 
WMt hos'p. dm " 


DRG 

num. 


Num. 
cases 


Case- 
mix 


Average length of stay 
We8t hosp. Dtw - 


1A 


214 


.047 


12.84 


15.36 


-2.52 


1B 


106 


.023 


13.48 


16.62 


-3.14 


1C 


10 


.002 


3.80 


7.62 


-3.82 


2A 


31 


.007 


9.26 


9.90 


-0.64 


2B 


163 


.036 


12.33 


13.17 


-0.84 


2C 


25 


.006 


10.16 


9.47 


0.69 


3A 


24 


.005 


16.88 


15.13 


1.75 


3B 


331 


.073 


2.76 


3.66 


-0.90 


3C 


59 


.013 


12.75 


13.28 


-0.53 


4A 


326 


.072 


2.74 


3.67 


-0.93 


4B 


299 


.066 


4.23 


5.31 


-1.08 


4C 


24 


.005 


14.63 


15.70 


-1.07 


5A 


468 


.104 


4.77 


5.77 


-1.00 


5B 


237 


.052 


5.57 


6.71 


-1.14 


5C 


40 


.009 


11.92 


13.36 


-1.44 


6A 


332 


.073 


7.22 


8.35 


-1.13 


6B 


237 


.052 


8.00 


9.03 


-1.03 


6C 


85 


.019 


13.86 


17.43 


-3.57 


7A 


402 


.089 


5.02 


5.99 


-0.97 


7B 


170 


.038 


4.44 


5.13 


-0.69 


7C 


26 


.006 


14.96 


17.50 


-2.54 


8A 


577 


.128 


9.19 


10.13 


-0.94 


8B 


122 


.027 


5.15 


6.47 


-1.32 


8C 


357 


.079 


2.78 


3.65 


-0.87 


9A 


131 


.029 


11.52 


11.78 


-0.26 


9B 


47 


.010 


7.34 


9.08 


-1.74 


9C 


166 


.037 


4.13 


5.07 


-0.94 


10A 


320 


.071 


6.60 


7.76 


-1.16 


10B 


275 


.061 


7.47 


8.77 


-1.30 


10C 


19 


.004 


4.95 


5.53 


-0.58 


11A 


394 


.087 


8.41 


10.00 


-1.59 


11B 


372 


.082 


10.37 


11.26 


-0.89 


11C 


643 


.142 


3.96 


5.29 


-1.33 


12A 


384 


.085 


8.01 


10.05 


-2.04 


12B 


294 


.065 


7.64 


9.69 


-2.05 


12C 


457 


.101 


5.77 


7.19 


-1.42 


13A 


133 


.029 


11.34 


12.83 


-1.49 


13B 


90 


.020 


9.22 


11.29 


-2.07 


13C 


221 


.049 


6.90 


8.69 


-1.79 


14A 


148 


.033 


2.89 


4.16 


-1.27 


14B 


313 


.069 


6.65 


7.81 


-1.16 


14C 


636 


.141 


6.72 


7.82 


-1.10 


15A 


78 


.017 


4.96 


6.44 


-1.48 


15B 


383 


.085 


8.37 


10.00 


-1.63 


15C 


1,043 


.231 


8.90 


10.03 


-1.13 


16A 


55 


.012 


4.49 


5.42 


-0.93 


16B 


49 


.011 


6.06 


6.59 


-0.53 


16C 


553 


.122 


9.70 


11.50 


-1.80 


17A 


36 


.008 


8.33 


9.74 


-1.41 


17B 


157 


.035 


3.07 


4.60 


-1.53 


17C 


156 


.035 


8.35 


10.93 


-2.58 


18A 


26 


.006 


4.85 


7.18 


-2.33 


18B 


56 


.012 


9.88 


11.64 


-1.76 














19A 


106 


.023 


8.03 


10.34 


-2.31 


19B 


77 


.017 


12.40 


13.86 


-1.46 














20A 


29 


.006 


3.90 


5.82 


-1.92 


20B 


742 


.164 


6.78 


8.13 


-1.35 














21A 


52 


.012 


9.33 


9.84 


-0.51 


























22A 


99 


.022 


4.03 


4.85 


-0.82 


























23A 


155 


034 


6.57 


8.55 


-1.98 



























Expected difference in LOS per case: —1.28. Expected difference in LOS per case: -1.31. Expected difference in LOS per case: -1.36. 



'Case-mix Proportion - number of cases in the DRG (NUM CASES) 

total number of cases for western hospitals (=4520) 

n 

Expected Difference =■ I (DIFF,) * (CASEMIX PRPRTN,), 
in LOS per case i = 1 

where i indexes DRG number and n-23, 20, and 17 for Schemes A, B, and C, respectively 



114 



Table 4.11 

Number of cases, case-mix proportion, average length of stay for nonteaching hospitals, average 
length of stay for all hospitals, and the difference in average length of stay between nonteaching 
hospitals and all hospitals, by DRG and classification scheme 1 



Scheme A Scheme B Scheme C 



DRG 
num. 


Num. 
cases 


Case- 
mix 
prprtn. 


Average length of stay 

No All nlM 
teach hosp. um - 


DRG 
num. 


Num. 
cases 


Case- 
mix 
prprtn. 


Average length of stay 

No All nm 
teach hosp. um - 


DRG 
num. 


Num. 
cases 


Case- 
mix 
prprtn. 


Average length of stay 

No All nlM 
teach hosp. um ' 


1A 


497 


.029 


15.16 


15.36 


-0.20 


1B 


265 


.015 


15.94 


16.62 


-0.68 


1C 


33 


.022 


6.88 


7.62 


-0.74 


2A 


149 


.009 


8.77 


9.90 


-1.13 


2B 


482 


.028 


12.66 


13.17 


-0.51 


2C 


83 


.005 


8.81 


9.47 


-0.66 


3A 


101 


.006 


14.71 


15.13 


-0.42 


3B 


1,792 


.103 


3.55 


3.66 


-0.11 


3C 


221 


.013 


12.14 


13.28 


-1.14 


4A 


1,758 


.101 


3.55 


3.67 


-0.12 


4B 


1,115 


.064 


5.10 


5.31 


-0.21 


4C 


43 


.002 


10.67 


15.70 


2.97 


5A 


1,749 


.101 


5.53 


5.77 


-0.24 


5B 


825 


.048 


6.43 


6.71 


-0.28 


5C 


94 


.005 


14.10 


13.36 


0.74 


6A 


1,135 


.065 


8.14 


8.35 


-0.21 


6B 


854 


.049 


8.78 


9.03 


-0.25 


6C 


210 


.012 


16.51 


17.43 


-0.92 


7A 


2,378 


.137 


5.77 


5.99 


-0.22 


7B 


1,217 


.070 


4.94 


5.13 


-0.19 


7C 


63 


.004 


17.32 


17.50 


-0.18 


8A 


2,080 


.120 


9.74 


10.13 


-0.39 


8B 


722 


.042 


6.17 


6.47 


-0.30 


8C 


1,900 


.110 


3.54 


3.65 


-0.11 


9A 


320 


.018 


11.07 


11.78 


-0.71 


9B 


216 


.012 


8.15 


9.08 


-0.93 


9C 


1,205 


.070 


4.88 


5.07 


-0.19 


10A 


1,262 


.073 


7.57 


7.76 


-0.19 


10B 


1,016 


.059 


8.50 


8.77 


-0.27 


10C 


98 


.006 


5.00 


5.53 


-0.53 


11A 


1,329 


.077 


9.51 


10.00 


-0.49 


11B 


1,239 


.071 


10.94 


11.26 


-0.32 


11C 


2,497 


.144 


5.05 


5.29 


-0.24 


12A 


1.229 


.071 


9.21 


10.05 


-0.84 


12B 


959 


.055 


8.87 


9.69 


-0.82 


12C 


2,074 


.120 


6.92 


7.19 


-0.27 


13A 


497 


.029 


12.25 


12.83 


-0.58 


13B 


270 


.016 


10.41 


11.29 


-0.88 


13C 


754 


.043 


8.10 


8.69 


-0.59 


14A 


484 


.028 


3.68 


4.16 


-0.48 


14B 


1,239 


.071 


7.62 


7.81 


-0.19 


14C 


2,212 


.128 


7.51 


7.82 


-0.31 


15A 


316 


.018 


5.99 


6.44 


-0.45 


15B 


1,296 


.075 


9.48 


10.00 


-0.52 


15C 


3,732 


.215 


9.64 


10.03 


-0.32 


16A 


206 


.012 


5.51 


5.42 


0.09 


16B 


206 


.012 


6.45 


6.59 


-0.14 


16C 


1,591 


.092 


10.87 


11.50 


-0.63 


17A 


89 


.005 


9.20 


9.74 


-0.54 


17B 


570 


.033 


4.21 


4.60 


-0.39 


17C 


528 


.030 


10.81 


10.93 


-0.12 


18A 


126 


.007 


6.78 


7.18 


-0.40 


18B 


244 


.014 


11.00 


11.64 


-0.64 














19A 


474 


.027 


9.88 


10.34 


-0.46 


19B 


252 


.015 


13.48 


13.86 


-0.38 














20A 


106 


.006 


5.50 


5.82 


-0.32 


20B 


2,559 


.148 


7.67 


8.13 


-0.46 














21 A 


141 


.008 


9.09 


9.84 


-0.75 


























22A 


390 


.022 


4.94 


4.85 


0.09 


























23A 


514 


.030 


8.62 


8.55 


0.07 



























Expected difference in LOS per case: -.33. Expected difference in LOS per case: -.36. Expected difference in LOS per case: -.33. 



'Case-mix Proportion - number of cases in the DRG (NUM CASES) 

total number of cases for nonteaching hospitals ( = 17,338) 

n 

Expected Difference - 1 (DIFF,) * (CASEMIX PRPRTN.,), 
in LOS per case i - 1 

where i indexes DRG number and n- 23, 20, and 17 for Schemes A, B, and C, respectively 



115 



Table 4.12 

Number of cases, case-mix proportion, average length of stay for minor teaching hospitals, average 
length of stay for all hospitals, and the difference in average length of stay between minor teaching 
hospitals and all hospitals, by DRG and classification scheme 1 



Scheme A Scheme B Scheme C 



DRG 

num. 


Num. 
cases 


Case- 
mix 
prprtn. 


Average length of stay 

Mln. All nlM 
teach hosp. um - 


DRG 
num. 


Num. 
cases 


Case- 
mix 
prprtn. 


Average length of stay 

Min. All nwf 
teach hosp. UITT - 


DRG 

num. 


Num. 
cases 


Case- 
mix 
prprtn. 


Average length of stay 

Min. All nlM 
teach hosp. um - 


1A 


353 


.060 


14.65 


15.36 


-0.71 


1B 


168 


.028 


15.68 


16.62 


-0.94 


1C 


16 


.003 


6.94 


7.62 


0.68 


2A 


64 


.011 


10.63 


9.90 


0.73 


2B 


303 


.051 


13.25 


13.17 


0.08 


2C 


55 


.009 


9.49 


9.47 


0.09 


3A 


54 


.009 


14.81 


15.13 


-0.32 


3B 


429 


073 


3.89 


3.66 


0.23 


3C 


130 


022 


14.23 


13.28 


0.95 


4A 


418 


.071 


3.92 


. 3.67 


0.25 


4B 


358 


.061 


5.59 


5.31 


0.28 


4C 


40 


.007 


13.25 


15.70 


-2.45 


5A 


567 


.096 


6.09 


5.77 


0.32 


5B 


265 


.045 


6.92 


6.71 


0.21 


5C 


54 


.009 


12.04 


13.36 


-1.32 


6A 


315 


.053 


8.39 


8.35 


0.04 


6B 


231 


.039 


9.13 


9.03 


0.10 


6C 


139 


.024 


16.90 


17.43 


0.53 


7A 


583 


.099 


6.49 


5.99 


0.50 


7B 


318 


.054 


5.46 


5.13 


0.33 


7C 


37 


.006 


17.24 


17.50 


0.23 


8A 


614 


.104 


10.62 


10.13 


0.49 


SB 


171 


.029 


7.44 


6.47 


0.97 


8C 


453 


.077 


3.94 


3.65 


0.23 


9A 


178 


.030 


13.38 


11.78 


1.60 


9B 


92 


.016 


10.33 


9.08 


1.25 


9C 


314 


.053 


5.32 


5.07 


0.25 


10A 


388 


.066 


7.65 


7.76 


-0.11 


10B 


227 


.038 


9.23 


8.77 


0.46 


10C 


28 


.005 


6.64 


5.53 


1.11 


11A 


457 


.077 


10.05 


10.00 


0.05 


1 1 B 


376 


.064 


11.71 


11.26 


0.45 


11C 


857 


.145 


5.63 


5.29 


0.34 


12A 


650 


.110 


10.22 


10.05 


0.17 


12B 


500 


.085 


9.82 


9.69 


0.13 


12C 


559 


.095 


7.55 


7.19 


0.36 


13A 


200 


.034 


13.42 


12.83 


0.59 


13B 


140 


.025 


11.55 


11.29 


0.26 


13C 


340 


.057 


9.32 


8.69 


0.83 


14A 


170 


.029 


4.68 


4.16 


0.52 


14B 


366 


.062 


7.71 


7.81 


-0.10 


14C 


735 


.124 


8.13 


7.82 


0.31 


15A 


130 


.022 


6.97 


6.44 


0.53 


15B 


443 


.075 


10.06 


10.00 


0.06 


15C 


1,135 


.192 


10.27 


10.03 


0.24 


16A 


90 


.015 


5.16 


5.42 


-0.26 


16B 


93 


.016 


6.77 


6.59 


0.18 


16C 


820 


.139 


11.77 


11.50 


0.23 


17A 


44 


.007 


10.73 


9.74 


0.99 


17B 


208 


.035 


5.06 


4.60 


0.46 


17C 


202 


.034 


10.66 


10.93 


-0.27 


18A 


45 


.008 


8.09 


7.18 


0.91 


18B 


89 


.015 


12.49 


11.64 


0.85 














19A 


191 


.032 


10.26 


10.34 


-0.08 


19B 


111 


.019 


14.16 


13.86 


0.30 














20A 


41 


.007 


7.02 


5.82 


1.20 


20B 


1,018 


.172 


8.80 


8.13 


0.67 














21A 


70 


.012 


9.80 


9.84 


-0.04 


























22A 


105 


.018 


4.56 


4.85 


-0.29 


























23A 


187 


.032 


8.41 


8.55 


-0.14 



























Expected difference in LOS per case: .23. Expected difference in LOS per case: .30. Expected difference in LOS per case: .25. 



'Case-mix Proportion -- number of cases in the DRG (NUM CASES) 

total number of cases for minor teaching hospitals ( = 5914) 

n 

Expected Difference = I (DIFF,) ' (CASEMIX PRPRTN.,), 
in LOS per case i - 1 

where i indexes DRG number and n-23, 20. and 17 for Schemes A, B. and C, respectively 



116 



Table 4.13 

Number of cases, case-mix proportion, average length of stay for major teaching hospitals, average 
length of stay for all hospitals, and the difference in average length of stay between major teaching 
hospitals and all hospitals, by DRG and classification scheme 



Scheme A Scheme B Scheme C 



DRG 
num. 


Num. 
cases 


Case- 
mix 
prprtn 


Average length of stay 


DRG 

num. 


Num. 
cases 


Case- 
mix 
prprtn 


Average length of stay 


DRG 

num. 


Num. 
cases 


Case- 
mix 
prprtn 


Average length of stay 


MaJ. 
teach 


All 
hosp. 


Dlff. 


Ma], 
teach 


All 
hosp. 


Dlff. 


MaJ. 
teach 


All 
hosp. 


Dlff. 


1A 


244 


.051 


16.80 


15.36 


1.44 


1B 


121 


.025 


19.40 


16.62 


2.78 


1C 


9 


.002 


11.56 


7.62 


3.94 


2A 


58 


.012 


12.02 


9.90 


2.12 


2B 


232 


.049 


14.13 


13.17 


0.96 


2C 


41 


.009 


10.80 


9.47 


1.33 


3A 


51 


.011 


16.27 


15.13 


1.14 


3B 


428 


.090 


3.87 


3.66 


0.21 


3C 


102 


.021 


14.54 


13.20 


1.26 


4A 


426 


.009 


3.89 


3.67 


0.22 


4B 


336 


.071 


5.71 


5.31 


0.40 


4C 


22 


.005 


14.36 


15.70 


-1.34 


5A 


501 


.105 


6.26 


5.77 


0.49 


5B 


220 


.046 


7.53 


6.71 


0.82 


5C 


33 


.007 


13.45 


13.36 


0.09 


6A 


259 


.054 


9.24 


8.35 


0.89 


6B 


178 


.037 


10.12 


9.03 


1.09 


6C 


119 


.025 


19.68 


17.43 


2.25 


7A 


487 


.102 


6.44 


5.99 


0.45 


7B 


252 


.053 


5.62 


5.13 


0.49 


7C 


27 


.006 


18.30 


17.50 


0.80 


8A 


471 


.099 


11.21 


10.13 


1.08 


8B 


149 


.031 


6.81 


6.47 


0.34 


8C 


456 


.096 


3.86 


3.65 


0.21 


9A 


142 


.030 


11.39 


11.78 


-0.39 


9B 


81 


.017 


10.16 


9.08 


1.08 


9C 


256 


.054 


5.64 


5.07 


0.57 


10A 


334 


.070 


8.60 


7.76 


0.84 


1 0B 


172 


.036 


9.78 


8.77 


1.01 


10C 


27 


.006 


6.30 


5.53 


0.77 


11A 


337 


.071 


11.91 


10.00 


1.91 


1 1 B 


291 


.061 


12.08 


11.26 


0.82 


11C 


736 


.155 


5.69 


5.29 


0.40 


12A 


536 


.113 


11.79 


10.05 


1.74 


12B 


418 


.088 


11.44 


9.69 


1.75 


12C 


451 


.095 


7.98 


7.19 


0.79 


13A 


110 


.023 


14.39 


12.83 


1.56 


13B 


118 


.025 


13.00 


11.29 


1.71 


13C 


286 


.060 


9.48 


8.69 


0.79 


14A 


144 


.030 


5.13 


4.16 


0.97 


14B 


319 


.067 


8.67 


7.81 


0.86 


14C 


551 


.116 


8.66 


7.82 


0.84 


15A 


103 


.022 


7.15 


6.44 


0.71 


15B 


322 


.068 


12.01 


10.00 


2.01 


15C 


896 


.188 


11.35 


10.03 


1.32 


16A 


53 


.011 


5.47 


5.42 


0.05 


16B 


52 


.011 


6.83 


6.59 


0.24 


16C 


600 


.126 


12.80 


11.50 


1.30 


17A 


34 


.007 


9.88 


9.74 


0.14 


17B 


168 


.035 


5.36 


4.60 


0.76 


17C 


149 


.031 


11.69 


10.93 


0.76 


18A 


25 


.005 


7.60 


7.18 


0.42 


18B 


39 


.008 


13.74 


11.64 


2.10 














19A 


132 


.028 


12.10 


10.34 


1.76 


19B 


71 


.015 


14.75 


13.86 


0.89 














20A 


51 


.011 


5.53 


5.82 


-0.29 


20B 


794 


.167 


8.77 


8.13 


0.64 














21A 


66 


.014 


11.48 


9.84 


1.64 


























22A 


98 


.021 


4.79 


4.85 


-0.06 


























23A 


99 


.021 


8.44 


8.55 


-0.11 



























Expected difference in LOS per case: .91. Expected difference in LOS per case: .94. Expected difference in LOS per case: .87. 



'Case-mix Proportion = number of cases in the DRG (NUM CASES) 

total number of cases for major teaching hospitals ( = 4761) 
n 

Expected Difference = I (DIFF,) * (CASEMIX PRPRTN.,), 
in LOS per case i = 1 

where i indexes DRG number and n - 23, 20, and 17 for Schemes A, B, and C, respectively 



117 



Table 4.14 

Number of cases, case-mix proportion, average length of stay for small (< 100 beds) hospitals, 
average length of stay for all hospitals, and the difference in average length of stay between small 
hospitals and all hospitals, by DRG and Classification scheme 1 



Scheme A Scheme B Scheme C 



DRG 

num. 


Num. 
cases 


Case- 
mix 


Average length of stay 
Sma " hSs'p. Dlff - 


DRG 
num. 


Num. 
cases 


Case- 
mix 
prprtn. 


Average length of stay 
Sma " hosp. Dlff - 


DRG 
num. 


Num. 
cases 


case- 
mix 
prprtn. 


Average length of stay 
Sma " hosp. Dm - 


1A 


29 


.008 


16.38 


15.36 


1.02 


1B 


12 


.003 


16.17 


16.62 


-0.45 


1C 


1 


.000 


8.00 


7.62 


0.38 


2A 


e 


.002 


8.50 


9.90 


-1.48 


2B 


41 


.011 


14.12 


13.17 


0.95 


2C 


2 


.001 


12.00 


9.47 


2.53 


3A 


16 


.004 


14.38 


15.13 


-0.75 


3B 


372 


.102 


3.46 


3.66 


-0.20 


3C 


25 


.007 


11.80 


13.28 


-1.48 


4A 


359 


.098 


3.44 


3.67 


-0.23 


4B 


255 


.070 


4.58 


5.31 


-0.73 


4C 


3 


.001 


27.00 


15.70 


11.30 


5A 


417 


.114 


4.59 


5.77 


— 1.18 


5B 


206 


.056 


5.18 


6.71 


-1.53 


5C 


8 


.002 


19.50 


13.36 


6.14 


6A 


298 


.082 


7.16 


8.35 


— 1.19 


6B 


235 


.064 


7.38 


9.03 


-1.65 


6C 


11 


.003 


14.82 


17.43 


— 2.61 


7A 


544 


.149 


5.22 


5.99 


— 0.77 


7B 


245 


.067 


4.45 


5.13 


— 0.68 


7C 


3 


.001 


15.33 


17.50 


— 2.17 


8A 


531 


.146 


8.37 


10.13 


— 1 .76 


8B 


177 


.049 


5.45 


6.47 


— 1 .02 


8C 


394 


.108 


3.49 


3.65 


— 0.16 


9A 


64 


.018 


9.39 


1 1 ,78 


— 2.39 


9B 


55 


.015 


7.58 


9.08 


— 1 .50 


9C 


246 


.067 


4.46 


5.07 


— 0.61 


10A 


268 


.073 


6.57 


7.76 


— 1.19 


10B 


283 


.078 


7.35 


8.77 


-1.42 


10C 


18 


.005 


3.89 


5.53 


-1.64 


11A 


310 


.085 


8.09 


10.00 


-1.91 


11B 


298 


.082 


9.43 


11.26 


-1.83 


11C 


556 


.152 


4.26 


5.29 


-1.03 


12A 


167 


.046 


7.59 


10.05 


-2.46 


12B 


147 


.040 


7.09 


9.69 


-2.60 


12C 


478 


.131 


5.85 


7.19 


-1.34 


13A 


92 


.025 


10.38 


12.83 


-2.45 


13B 


20 


.005 


11.25 


11.29 


-0.04 


13C 


119 


.033 


6.49 


8.69 


-2.20 


14A 


101 


.028 


3.35 


4.16 


-0.81 


14B 


267 


.073 


6.53 


7.81 


-1.28 


14C 


506 


.139 


6.70 


7.82 


-1.12 


15A 


72 


.020 


5.46 


6.44 


-0.98 


15B 


308 


.084 


8.06 


10.00 


-1.94 


15C 


900 


.247 


8.53 


10.03 


-1.50 


16A 


24 


.007 


4.88 


5.42 


-0.54 


16B 


23 


.006 


6.43 


6.59 


-0.16 


16C 


266 


.073 


9.32 


11.50 


-2.18 


17A 


10 


.003 


9.70 


9.74 


-0.04 


17B 


125 


.034 


3.70 


4.60 


-0.90 


17C 


113 


.031 


9.23 


10.93 


-1.70 


18A 


20 


.005 


3.90 


7.18 


-3.28 


18B 


43 


.012 


9.35 


11.64 


-2.29 














19A 


94 


.026 


9.76 


10.34 


-0.58 


19B 


49 


.013 


11.29 


13.86 


-2.57 














20A 


14 


.004 


5.07 


5.82 


-0.75 


20B 


488 


.134 


6.94 


8.13 


-1.19 














21A 


21 


.006 


8.05 


9.84 


-1.79 


























22A 


78 


.021 


3.86 


4.85 


-0.99 


























23A 


112 


.031 


8.25 


8.55 


-0.30 



























Expected difference in LOS per case: -1.21. Expected difference in LOS per case: -1.25. Expected difference in LOS per case: -1.20. 



'Case-mix Proportion =- number of cases in the DRG (NUM CASES) 

total number of cases for small hospitals (=3,649) 

n 

Expected Difference = 1 (DIFF,) * (CASEMIX PRPRTN.,), 
in LOS per case i = 1 

where i indexes DRG number and n^23, 20, and 17 for Schemes A, B, and C, respectively 



118 



Table 4.15 



Number of cases, case-mix proportion, average length of stay for medium (100-399 beds) hospitals, 
average length of stay for all hospitals, and the difference in average length of stay between medium 
hospitals and all hospitals, by DRG and classification scheme 1 



Scheme A Scheme B Scheme C 



DRG 

num. 


Num. 
cases 


Case- 
mix 
prprtn. 


Average length of stay 

Medl- All nm 
urn Hosp. Dm - 


DRG 
num. 


Num. 
cases 


Case- 
mix 
prprtn. 


Average length of stay 

Medl- All nlM 
urn Hosp. Dm - 


DRG 

num. 


Num. 
cases 


Case- 
mix 
prprtn. 


Average length of stay 

Medl- All nlM 
urn Hosp. Dm - 


1A 


483 


.033 


15.06 


15.36 


— 0.30 


1B 


247 


.017 


16.81 


16.62 


0.19 


1C 


26 


.002 


6.27 


7.62 


— 1.35 


2A 


128 


.009 


8.48 


9.90 


— 1 .42 


2B 


466 


.032 


12.29 


13.17 


— .088 


2C 


90 


.006 


8.79 


9.47 


— 0.68 


3A 


102 


.007 


14.91 


15.13 


—0.22 


3B 


1,439 


.099 


3.62 


3.66 


— 0.04 


3C 


217 


.015 


12.46 


13.20 


—0.82 


4A 


1,412 


.097 


3.64 


3.67 


— 0.03 


4B 


946 


.065 


5.35 


5.31 


0.04 


4C 


43 


.003 


14.79 


15.70 


—0.91 


5A 


1,490 


.102 


5.89 


5.77 


0.12 


5B 


692 


.048 


6.87 


6.71 


0.16 


5C 


75 


.005 


13.04 


13.36 


— 0.32 


6A 


911 


.063 


8.46 


8.35 


0.1 1 


6B 


680 


.047 


9.21 


9.03 


0.18 


6C 


201 


.014 


1 7.57 


17.43 


0.14 


7A 


1,879 


.129 


6.06 


5.99 


0.07 


7B 


996 


.068 


5.03 


5.13 


— 0.10 


7C 


61 


.004 


1 7.67 


17.50 


0.1 7 


8A 


1,712 


.118 


10.23 


10.13 


U. I u 


8B 


559 


.038 


D.D 1 


6.47 


0.14 


8C 


1,518 


.104 


3.60 


3.65 


— 0.05 


9A 


320 


.022 


1 1.90 


1 1 .78 


U. I c 


9B 


207 


.014 


8 33 


9.08 


— 0.75 


9C 


993 


.068 


4.97 


5.07 


— 0.10 


10A 


1,034 


.071 


7.64 


7.76 


—0.12 


10B 


755 


.052 


9.07 


8.77 


0.30 


10C 


83 


.006 


5.18 


5.53 


— 0.35 


11A 


1,108 


.076 


10.05 


10.00 


0.05 


11B 


1,032 


.071 


11.59 


11.26 


0.33 


11C 


2,091 


.142 


5.41 


5.29 


0.12 


12A 


1,140 


.078 


9.56 


10.05 


-0.49 


12B 


868 


.060 


9.14 


9.69 


-0.55 


12C 


1,630 


.113 


7.32 


7.19 


0.13 


13A 


410 


.028 


13.22 


12.83 


0.39 


13B 


272 


.019 


10.90 


11.29 


-0.39 


13C 


630 


.044 


8.68 


8.69 


-0.01 


14A 


366 


.025 


4.10 


4.16 


-0.06 


14B 


1,006 


.069 


7.69 


7.81 


-0.12 


14C 


1,833 


.126 


7.78 


7.82 


-0.04 


15A 


257 


.018 


6.72 


6.44 


0.28 


15B 


1,079 


.074 


10.02 


10.00 


0.02 


15C 


3,060 


.210 


10.01 


10.03 


-0.02 


16A 


183 


.013 


5.32 


5.42 


-0.10 


16B 


196 


.013 


5.99 


6.59 


-0.60 


16C 


1,513 


.104 


11.28 


11.50 


-0.22 


17A 


91 


.006 


8.20 


9.74 


-1.54 


17B 


451 


.031 


4.74 


4.60 


0.14 


17C 


482 


.033 


11.00 


10.93 


0.07 


18A 


101 


.007 


7.48 


7.18 


0.30 


18B 


191 


.013 


11.68 


11.64 


0.04 














19A 


430 


.030 


9.88 


10.34 


-0.46 


19B 


218 


.015 


14.60 


13.86 


0.74 














20A 


100 


.007 


5.87 


5.82 


0.05 


20B 


2,242 


.154 


8.08 


8.13 


-0.05 














21 A 


144 


.010 


9.45 


9.84 


-0.39 


























22A 


300 


.021 


5.05 


4.85 


0.20 


























23A 


433 


.030 


8.41 


8.55 


-0.14 



























Expected difference in LOS per case: -.04. Expected difference in LOS per case: -.03. Expected difference in LOS per case: -.03. 



'Case-mix Proportion = number of cases in the DRG (NUM CASES) 

total number of cases for medium hospitals (=14,452) 
n 

Expected Difference = 2 (DIFF,) *. (CASEMIX PRPRTN,), 
in LOS per case i = 1 

where i indexes DRG number and n = 23, 20, and 17 for Schemes A, B, and C, respectively 



419-177 O - 84 -- 9 



119 



Table 4.16 

Number of cases, case-mix proportion, average length of stay for large (400 + beds) hospitals, 
average length of stay for all hospitals, and the difference in average length of stay between large 
hospitals and all hospitals, by DRG and classification scheme 1 



Scheme A Scheme B Scheme C 



DRG 

num. 


Num. 
cases 


Case- 
mix 
prprtn. 


Average length of stay 


DRG 

num. 


Num. 
cases 


C2S5- 


Average Length of stay 


DRG 
num. 


Num. 
cases 


Case- 
mix 
prprtn. 


Average length of stay 


Large 


All 
hosp. 


Dlff. 


mix 
prprtn. 


Large 


All 
hosp. 


Dlff. 


Large 


All 
hosp. 


Dlff. 


1 A 


582 


.059 


15.56 


15.36 


0.20 


1B 


295 


.030 


16.48 


16.62 


-0.14 


1C 


31 


.003 


8.74 


7.62 


1.12 


2A 


135 


.014 


11.33 


9.90 


1.43 


2B 


510 


.052 


13.90 


13.17 


0.73 


2C 


87 


.009 


10.13 


9.47 


0.66 


3A 


88 


.009 


15.51 


15.13 


0.38 


3B 


838 


.085 


3.81 


3.66 


0.15 


3C 


211 


.021 


14.31 


13.28 


1.03 


4A 


831 


.085 


3.83 


3.67 


0.16 


4B 


608 


.062 


5.57 


5.31 


0.26 


4C 


59 


.006 


15.80 


15.70 


0.10 


5A 


910 


.093 


6.13 


5.77 


0.36 


5B 


412 


.042 


7.21 


6.71 


0.50 


5C 


98 


.010 


13.11 


13.36 


-0.25 


6A 


500 


.051 


8.80 


8.35 


0.53 


6B 


348 


.035 


9.81 


9.03 


0.78 


6C 


256 


.026 


17.44 


17.43 


0.01 


7A 


1,025 


.104 


6.25 


5.99 


0.26 


7B 


546 


.056 


5.61 


5.13 


0.48 


7C 


63 


.006 


17.44 


17.50 


-0.06 


8A 


930 


.095 


10.96 


10.13 


0.83 


SB 


306 


.031 


6.81 


6.47 


0.34 


8C 


897 


.091 


3.82 


3.65 


0.17 


9A 


256 


.026 


12.23 


11.78 


0.45 


9B 


127 


.013 


10.95 


9.08 


1.87 


9C 


536 


.055 


5.53 


5.07 


0.46 


10A 


682 


.069 


8.40 


7.76 


0.64 


10B 


377 


.038 


9.25 


8.77 


0.48 


10C 


52 


.005 


6.65 


5.53 


1.12 


11A 


705 


.072 


10.77 


10.00 


0.77 


11B 


576 


.059 


11.64 


11.26 


0.38 


11C 


1,463 


.149 


5.51 


5.29 


0.22 


12A 


1,108 


.113 


10.93 


10.05 


0.88 


12B 


862 


.088 


10.70 


9.69 


1.01 


12C 


968 


.099 


7.63 


7.19 


0.44 


13A 


305 


.031 


13.05 


12.83 


0.22 


13B 


244 


.025 


11.74 


11.29 


0.45 


13C 


623 


.063 


9.11 


8.69 


0.42 


14A 


331 


.034 


4.47 


4.16 


0.31 


14B 


651 


.066 


8.53 


7.81 


0.72 


14C 


1,159 


.118 


8.37 


7.82 


0.55 


15A 


220 


.022 


6.42 


6.44 


-0.02 


15B 


674 


.069 


10.86 


10.00 


0.86 


15C 


1,803 


.184 


10.82 


10.03 


0.79 


16A 


142 


.014 


5.63 


5.42 


0.21 


16B 


132 


.013 


7.50 


6.59 


0.91 


16C 


1,232 


.125 


12.24 


11.50 


0.74 


17A 


66 


.007 


11.88 


9.74 


2.14 


17B 


703 


.038 


4.74 


4.60 


0.14 


17C 


284 


.029 


11.49 


10.93 


0.56 


18A 


75 


.008 


7.67 


7.18 


0.49 


18B 


138 


.014 


12.30 


11.64 


0.66 














19A 


265 


.027 


11.31 


10.34 


0.97 


19B 


167 


.017 


13.66 


13.86 


-0.20 














20A 


84 


.009 


5.89 


5.82 


0.07 


20B 


1,641 


.167 


8.56 


8.13 


0.43 














21A 


112 


.011 


10.68 


9.04 


0.84 


























22A 


215 


.022 


4.92 


4.85 


0.07 


























23A 


255 


.026 


8.92 


8.55 


0.37 



























Expected difference in LOS per case: .51. Expected difference in LOS per case: .52. Expected difference in LOS per case: .50. 



'Case-mix Proportion = number of cases in the DRG (NUM CASES) 
total number of cases for large hospitals (=9,822) 

n 

Expected Difference = I (DIFF,) * (CASEMIX PRPRTN.,), 
in LOS per case i = 1 

where i indexes DRG number and n = 23, 20, and 17 for Schemes A, B, and C, respectively 



120 



Summary 

Based on the general structure of the three 
classification schemes, it appears that Teams A and B 
adopted a similar conceptual framework and 
operational definitions for the DRGs. This was 
especially true for medical patients, that both teams 
initially partitioned into generally homogeneous 
subgroups of principal diagnoses: bronchitis/asthma, 
pneumonia, chronic obstructive pulmonary disease, 
neoplasms, pulmonary embolism, pneumothorax, and 
selected signs and symptoms. The major area of 
disagreement was in the remaining diagnoses which 
Team B grouped together into an "other diagnoses" 
group, while Team A chose to isolate further: 
respiratory infections and inflammations, interstitial 
lung diseases, and pleural effusion and pulmonary 
edema. Both teams further partitioned these groups on 
the basis of age and comorbidities/complications, 
although not always in a similar manner. Team C, on 
the other hand, deviated from the guidelines and 
initially partitioned medical patients on the use of a 
respirator. The nonrespiratory subgroup was then 
divided into 3 groups based on the combination of age 
and comorbidities/complications. These were divided 
into diagnostic subgroups, which were observed to be 
less homogeneous in terms of principal diagnosis than 
their counterparts in Schemes A and B. 

There was a statistically significant level of 
agreement between all pairs of schemes. Schemes A 
and B were in highest agreement, and Schemes B and 
C in lowest, although the differences were not great. 
It appeared from the cross tabulations of patients by 
DRGs within schemes, that this significant level of 
agreement was achieved by the teams essentially 
grouping together similar sets of patients. That is, 
regardless of the variables used to define DRGs, the 
particular process in all three schemes resulted in 
generally the same large subgroups of patients being 
isolated from the others. 

Finally, length-of-stay comparisions for selected 
types of hospitals (northeastern, north central, south, 
west; large, medium, small; nonteaching, minor 
teaching, major teaching) versus all hospitals revealed 
generally consistent findings regardless of the 
particular scheme used to adjust for differences in 
case mix. There was therefore no evidence to suggest 
that a certain type of hospital would compare more 
or less favorably under one of the three classification 
systems than another. 

Technical reference 

The approach taken to measuring agreement among 
different systems of classification is a method 
developed by Klastorin and Watts (Klastorin, 1980). 
This measure assesses the extent to which two 
classification schemes "agree" in their partitioning of 
patient records. 

Measuring agreement among different systems of 
classification problem. Each of two teams of physicians 



independently partitions a set of patient records (for 
example, from a major diagnostic category) into n and 
n groups (for example DRGs), respectively, where 
the groups are defined by the levels of one or more 
independent variables. The classification schemes 
designed by each team may differ in terms of the 
number of groups or partitions as well as by the 
variables used to define them. For example, suppose 
each team examined the set of records corresponding 
to Major Diagnostic Category 4, Diseases and 
Disorders of the respiratory System. Team A decided 
to partition the set into two groups (DRGs) based on 
whether or not an operating room procedure was 
performed. Team B partitioned the set into three 
groups based on principal diagnosis. This may be 
illustrated as: 

Classification of Major Diagnostic Category 04: 
Diseases and disorders of the Respiratory system 

Team A Team B 

DRG 1: With Operating DRG 1: Principal 

Room Procedure Diagnoses X 

DRG 2: Without DRG 2: Principal 

Operating Room Diagnoses Y 

Procedure 

DRG 3: Principal 

Diagnoses Z 

The problem is to determine a measure that assesses 
the extent to which the two classification schemes 
"agree" in their partitioning of patient records. 
Method. Define two classification schemes 
corresponding to the MDC of interest as Scheme A 
and Scheme B. The groups or partitions that comprise 
each scheme are referred to as DRG's. 
All pairs of patient records in the MDC are formed, 
and each pair is then examined to determine which 
one of the following statements is true: 

• The members of the pair are assigned to the same 
DRG by both schemes. 

• The members of the pair are assigned to the same 
DRG by Scheme A but to different DRGs by 
Scheme B. 

• The members of the pair are assigned to the same 
DRG by Scheme B but to different DRGs by 
Scheme A. 

• The members of the pair are assigned to different 
DRGS by both schemes. 

Compute the total number of pairs for which 
statement 1 is true, for which statement 2 is true, etc. 
and summarize the results in a table of the following 
form: 

Scheme A 







Assignment to same 






DRG: 








Yes No 




Scheme B 








Assigned to 


Yes 


n n 


n 


same DRG: 


No 


n n 


n 






n. n. 


n. . 



121 



The proportion of agreement, the proportion of 
agreement corrected for that expected by chance 
alone, and a Kappa-type index of agreement may then 
be calculated from the table in the following manner 
(Klastorin, Andrews, et al., 1972): 

Proportion of Agreement: 
S m =(n u +n 22 )/n.. 

Corrected Proportion of Agreement: 
S m -E(S m ) 
Index of Agreement: 
S m -E(S m ) 



K(S m ) = - 



where E(S m ) = 



l"E(S m ) 

n,.n.! + n 2 .n. 2 



n^.. 



The variance of K( m ) is: 

Var(S m ) 



var (K(S m )) = - 



[l-E(S m )] 2 



where var (S m ) may be determined from equation (9) 
on page 8 of Klastorin (Andrews, et al., 1972). 
The statistical significance of Kappa is tested using 
the statistic 



Z = K(S m )/V va(K(S m )) 



which is distributed N(0,1). 
Example. Suppose, that Team A partitioned the 
records in MDC 4 into two groups based on surgery, 
and Team B into three groups based on primary 
diagnosis. Assume there were 10 records (labelled A 
through J) in MDC 4, and that these 10 records were 
assigned to DRGs in the following manner by each 
scheme: 



Scheme A 

DRG 1: A,B,C,D, 

DRG 2: E,F,G,H,I,J 



Scheme B 
DRG 1: A,C,D 
DRG 2: E,F,G,H,I 
DRG 3: B,J 



The following is a list of all possible pairs of records 
and how they were classified by schemes A and B: 



Pair 



Same DRG 



Yes 



No 



AB X 

AC X 

AD X 

AE 

AF 

AG 

AH 

Al 

A J 

BC X 

BD X 

BE 

BF 

BG 

BH 

Bl 

BJ 

CD X 

CE 

CF 

CG 

CH 

CI 

CJ 

DE 

DF 

DG 

DH 

Dl 

DJ 

EF X 

EG X 

EH X 

EI X 

EJ X 

FG X 

FH X 

FI X 

FJ X 

GH X 

GI X 

GJ X 

HI X 

HJ X 

IJ X 



Same DRG 



Yes 



No 



122 



The summary table may be constructed as:* 

Scheme A 

Assigned to same DRG: 
Yes No 



Scheme B 



Assigned to 


yes 


13 


1 


14 


same DRG 




8 


23 


31 






21 


24 


45 



The measures of agreement are therefore computed 
as: 

Proportion of Agreement:" m = 36/45 = .80 
Corrected Proportion of Agreement: 

S m -E(S m ) = .80-.51 = .29 

where 



/ (14)(21) = (31)(24) \ 
E(Sm) "\ (45) 2 / 

= 1038/2025 = .51 



Index of Agreement: K(~ m ) = .29/.49 = .59 
The variance of K(~ m ) is 

var (K(~ m))=- 02022 



so that 



Z=^-=4.15 
.142 



Thus since Z = 4.15 > Z c = 2.576 (the critical value 
for a = .01), we conclude the observed degree of 
agreement is significant. 



*In practice, not all pairs need to be enumerated as 
illustrated. The alternative method is partly based on 
material found in Klastorin, 1978. 



Alternative method. The summary 2X2 table whose 
cells (nn, ni2, n2i, n22) contain the number of pairs 
grouped together by both partititons, the number of 
pairs grouped together by one partition and not the 
other, etc., can be constructed from the table that 
presents the cross classification of records by each 
partitioning scheme. The table denotations are: 



Scheme A 



DRG 







1 


2 


c 






1 


an 


ai2 


ai c 


ai. 


Scheme B DRG 


2 


a2i 


a22 


a 2c 


a 2 . 




r 


a r i 


a r 2 


a rc 


a r . 






a.i 


a. 2 


a. c 


a.. 



Scheme A partitions records into C DRGs and B into 
r DRGs. Each cell in the table, a^, contains the 
number of records classified into the i'th DRG by 
Scheme B and the j'th DRG by Scheme A. As such, 
the cell count (a^) represent the numbers of records 
grouped together by both schemes. The marginals of 
the table, that is the row and column totals, represent 
the numbers of records grouped together by one 
scheme or the other. In this table, the row totals (aj.) 
are the numbers of records grouped together by 
Scheme B and the column totals (a.j) are the numbers 
of records grouped together by Scheme A. Thus, 
(1) The number of pairs of records grouped together 
by Scheme A and Scheme B is 

i=lj = l \z / 



(2) The number of pairs of records grouped together 
by Scheme B and not by Scheme A is 



n 




(3) The number of pairs of records grouped together 
by Scheme A and not by Scheme B is 




123 



(4) The number of pairs of records not grouped 
together by either Scheme is 




n(n— 1 for n>2 
for n < 2 



By way of clarification of the table, an =3 since 3 
records (A,C,D) were classified into DRG 1 by 
Scheme B and into DRG 1 by Scheme A. Likewise, 
a3i = 1 since 1 record (B) was classified into DRG 3 
by Scheme B and into DRG 1 by Scheme A. We may 
then compute nu, ni 2 , n 2 2 as follows: 

<"-(K)+(K)+(H) 



Example. Consider the sample data presented earlier. 
Scheme A partitions records into 2 groups and B into 
3 groups. Assume there were 10 records (labelled A 
through J) and that these 10 records were assigned to 
DRGs in the following manner by each scheme: 



Scheme A 
DRG 1: A,B,C,D 
DRG 2: E,F,G,H,I,J 



Scheme B 
DRG 1: A,C,D 
DRG 2: E,F,G,H,I 
DRG 3: B,J 



The table that presents the cross classification of 
records by each partitioning scheme is then: 

Scheme A 

DRG 



= 3 + + 0+10 + + 0=13 

< 2 >n,^) + (H)->3 
= 3 + 20 + 2-13 = 1 

(3>n^(H)-'3 

= 6+15-13 = 8 

(4) n 22 = ( 1 2 °)— 13 — 1-8 

45-13-1-8 = 23 





1 


3 





3 


Scheme B DRG 


2 





5 


5 




3 


1 


1 


2 






4 


6 


10 



124 



Section 5: Concluding remarks 

Building on the experience gained in the 
development and applications of the 383 version of 
DRGs, the ICD-9-CM Diagnosis Related Groups 
were created. The current set of 467 DRGs were 
constructed in light of major changes in coding 
conventions from ICD-8 to ICD-9-CM. This 
resulted in the formation of a classification scheme 
with a manageable number of patient classes that are 
exhaustive and mutually exclusive with respect to the 
types of patients treated. These classes of patients are 
differentiated by specific demographic, diagnostic, 
therapeutic characteristics, and disposition. 

Within each DRG patients have similar clinical 
attributes and have demonstrated consistent and stable 
patterns of hospital length of stay and cost. DRGs 
provide a meaningful unit of measurement for 
purposes of comparison. A hospital's case-mix refers 
to the relative proportions of different types of 
patients as described in terms of the DRGs that a 
particular hospital treats. 

In conclusion, we have addressed many of the 
shortcomings associated with the 383 version of the 
DRGs. The most noteable changes include: 

Development of ICD-9-CM DRG based on 
ICD-9-CM diagnosis and procedure codes. The 
ICD-9-CM scheme represents a major refinement in 
classification. The development of ICD-9-CM DRGs 
eliminates the mapping of ICD-9-CM to HICDA-2 
(with, a loss in precision) and, the assignment into 383 
version of the DRGs using the HICDA-2 group 
definitions. 

Improved data base. Over a million and a half patient 
records from the CPHA acute care short term 
hospital data base were made available under the 
terms of subcontract to conduct this investigation. 
This national data base was stratified on region of the 
country, bed size, standard statistical metropolitan 
area, and teaching status. The reliability and validity 
of these records were evaluated and tested by CPHA 
prior to HSMGs receipt of the data. Additionally, a 
New Jersey Cost Data base was obtained. This cost 
data base successfully replicated the grouping strategy 
verifying the hypothesis that for each MDC, the same 
DRGs would result from change of the dependent 
variable (both length of stay and cost were used as 
dependent variables). 

Expanded participation. Involvement in project 
activities was sought from a diversity of individuals 
and organizations. A multidisciplinary Steering 
Committee comprised of physicians, statisticians, a 
medical records consultant, and health services 
researchers was established in the initial phase of the 
project charged with responsibility overseeing the 
project. Under the terms of the subcontract CPHA 
reassembled the physician task force that assisted 
CPHA in the development of the ICD-9-CM 
classification. The charge of this committee for 
purposes of this project was to review the clinical 
decisions judgments of the physician team in defining 
DRGs. 



Organ system approach. In defining MDCs the organ 
system approach was used because medical practice is 
primarily by speciality that is based on body systems. 
Therefore, most of the etiological organization of 
ICD-9-CM was reorganized into the organ system 
involved. 

Emphasis on clinical coherence. The previous version 
relied almost solely on statistical recommendations for 
establishing decisions in the partitioning process 
whereas, in this version clinical judgments were given 
a high priority. Organizing principles were developed 
to facilitate the formation DRGs and to provide for 
consistency within and among MDGs. 

Creation of operating room procedure variable and 
surgical health assignments. An operating procedure 
was defined as a procedure, based on clinical 
judgement, that would in most hospitals be performed 
in an operating room. An additional new feature of 
the operating room procedure subroutine was the 
establishment of a surgical hierarchy. For each MDC, 
operating room procedures were ranked from the 
most to least resource intensive based on the clinical 
judgment of the physician team. 

Creation of comorbidity and/or complication variable. 
Rather than categorizing patients based upon the 
presence or absence of any secondary diagnosis or 
counting the numbers of such diagnoses, specific lists 
of "substantial" complications and comorbidities were 
created. The entire list of secondary diagnoses on the 
patient's record is scanned. Substantial comorbidity 
and/or complication was sometimes used in 
combination with age. 

Not all patient abstracts are assigned to DRGs. There 
are several reasons a patient may not be assigned to 
one of the 467 DRGs: 

• The medical record information necessary for 
assignment to a specific DRG may be invalid 

• Selected invalid principal diagnoses are not assigned 
to specific MDCs. 

• Incompatible operating room procedures and 
diagnoses. 

This provides an approach to identify and correct 
coding errors thereby improving data reliability and 
validity. 

Future implications 

As more comprehensive and reliable patient 
information are made available, and as the practice of 
medicine continues to evolve, the DRGs must adapt 
to these changes. The technology and strategy used in 
the construction of DRGs can be applied in the 
development of future generations of classification 
schemes as was done in this major revision of 383 
version of the DRGs. Technical improvements 
achieved in the new ICD-9-CM DRG, make it 
virtually impossible (short of actual fraud) to upgrade 
patient, commonly referred to as "DRG creep" 
(Simborg, 1981). 



125 



Further, the refinements will make the DRGs a 
valuable tool for comparing and measuring the 
different types of patients among institutions and 
regions. Comparative analyses are useful to hospitals 
as they address such issues as: problem identification, 
objective setting, utilization review, impact 
assessment, hospital planning, cost modeling, 
budgeting, rate setting implications, and case-mix 
changes. 

Limitations 

While ICD-9-CM the classification scheme 
represents an advance in diagnostic and procedural 
coding, there are still some limitations of the coding 
scheme for describing patients and their associated 
consumption of hospital resources. Some diagnosis 
and procedure codes are too broad in definition. In 
general, it would have been desirable for the ICD-9- 
CM procedure codes to be more detailed with respect 
to the specification of the extent of a particular 
procedure. Additionally, the ICD-9-CM scheme is 
not consistent in the level of information provided 
across procedure and diagnostic categories. Eye 
diseases and procedures are very specific, while 
diseases and procedures of the circulatory system lack 
the same level of specificity. Indeed, some state of the 
art procedures in the circulatory system lacked codes 
to differentiate and identify them. For example: 

38.0 through 38.99 Incisions, excisions, and 
occlusion of vessels. 

The third digit identifies the type of procedure. 
These are in many cases too vague, i.e., incision 
of vessel, excision, of vessel, occlusion of vessel. 
The fourth digit (0-9) identifies the vessel site, 
but the categories are much too broad, including 
arteries and veins, as well as many different 
important vessels in the same group. This does 
not allow for accurate classification of the 
complexity of some peripheral vascular 
procedures. 

39.1 Intra-abdominal venous shunts. 

There is no way to distinguish between various 
shunts, i.e., mesocaval, portacaval, splenorenal, 
etc. 

39.25 Aortra-iliac femoral bypass. 

There is no way to distinguish between 
aortiofemoral, aortoiliac, aortopopliteal, 
iliofemoral shunts. 

39.24 Other (peripherial) vascular shunt or bypass. 



Groups a hodge-podge of shunts of both upper 
and lower extremities into one group. 
The entire section of peripheral vascular procedures 
(38.0 through 39.99) with very few exceptions is 
extremely non-specific. Clearly at times the ICD-9- 
CM codes do not allow for the precision desired by 
the clinicians who were responsible for the 
development of this version of the DRG's. 

Inconsistencies and inaccuracies in coding were 
evidence from review of the data-base: 

• Newborns not specified as to whether they were 
single, multiple, alive or stillborn. 

• Use of adult disease codes used for newborns. 

• Incompatible disease and procedure codes. 

• Use of Not Elsewhere Classified (NEC) and Not 
Otherwise Specified (NOS) codes when it was 
obvious that a more specific code could have been 
selected. 

• Maternity case not specified whether delivered, 
antipartum or postpartum. 

It was apparent that careful abstracting and coding 
would permit more accurate groupings. Hopefully in 
the future, this will come about, and many of the 
vague DRGs will disappear. 

Although the ICD-9-CM classification scheme has 
some limitations, it does represent a significant 
improvement over ICD-8, and provided the basis for 
refinement in the definitions of the DRGs. 

The DRGs are limited to the UHDDS data 
elements collected on all medical record abstracting 
systems. The precise patient characteristics used to 
form the DRGs differed for each MDC and were 
based on the evaluation of large amounts of historical 
patient data. There were several variables that were 
unavailable but would have been desirable to have 
evaluated in forming and defining the ICD-9-CM 
version of the DRGs. It would have been useful: 

• To have a better indication of the reason the patient 
was admitted to the hospital. The development of 
an operational definition for reason for admission 
would involve the consideration of variables such 
as admitting diagnosis, admitting status (emergency, 
urgent, or elective), readmission status and whether 
the diagnosis was known when the patient was 
admitted for treatment. For instance, did a 
diagnostic workup need to be performed at the time 
of admission. 

• Whether a patient was admitted for terminal care. 

• In the area of psychiatry to have better information 
on the treatment modality (i.e., psychotherapy, 
drugs etc.). 



126 



References 

Andrews, D.F., Bickel, Hampel, et al.: Robust Estimates of 
Location. Princeton University Press, 1972. 

Ament, R.P., Dreschslin, J.L., Kobrinski, E.J., and Wood, 
W.R.: A Study to Develop and Test Measures of Case Mix 
Complexity and Case Mix Severity for Hospitals. Final 
Report. 

Autosel: An A UTOGRP Subfile Creation Utility. Yale 
University, Institution for Social and Policy Studies, Center 
for Health Studies, 1978. 

Bayes, C.W.: Case-mix differences between non-profit and 
for profit hospitals. Inquiry 14:17, 1977. 

Commission on Professional and Hospital Activities: 
Hospital Adaptation of ICDA, 2nd Edition. Ann Arbor, 
Commission on Professional and Hospital Activities, 1968. 

Elia, R., and Freeman, J.L.: AUTOGRP/SAS Interface. 
Yale University, Institution for Social and Policy Studies, 
Center for Health Studies, 1978. 

Feldstein, M.: Hospital cost variation and case mix 
differences. Medical Care 3: 95, 1965. 

Fetter, R.B., Shin, Y., Freeman, J.L., et al.: Case-mix 
definition by diagnosis-related groups. Medical Care 18: 2, 
1980. 

Center for Health Studies: Diagnosis-Related Group Reports 
for PSRO Databases. Yale University, Center for Health 
Services, 1978. 

Klastorin, T.D. A Comprehensive Approach to the Partition 
Comparison Problem. Working Paper, Graduate School of 
Business, University of Washington, Seattle, Nov. 1978. 

Klastorin, T.D., and Watts, C.A.: The impact of case mix 
measures in hospital classification. Presented at the 
International Conference on Systems Science in Health 
Care. Montreal, July 1980. 

Lave, J.R., and Lave, L.B.: The extent of role 
differentiation among hospitals. Health Services Research 6: 
15, 1971. 

Lee, M.L., and Wallace, R.L.: Classification of diseases for 
hospital cost analysis. Inquiry 9: 69, 1972. 

Lee, M.L., and Wallace, R.L.: Problems in estimating 
multiproduct cost functions: an application to hospitals. 
Western Economic Journal 11: 350, 1973. 



Liston, H., and Turoff, M. (eds.): The Delphi Method: 
Techniques and Applications. Addison-Wesley, Reading, MA, 
I 1975. 

McClain, J.O.: Aids to Utilization Review: A Decision 
Problem in a Hospital Setting. Unpublished doctoral 
dissertation, Yale University, 1970. 

Mills, R., Fetter, R., and Averill, R.: CML Users Manual. 
Yale University Institution for Social and Policy Studies, 
Center for Health Studies, 1978. 

Mills, R., Fetter, R., Riedel, D.C., and Averill, R.F.: 
AUTOGRP, An interactive computer system for analysis of 
health care data. Medical Care 14(7): 603, 1975. 

Public Health Service/Health Care Financing 
Administration: International Classification of Diseases — 9th 
Revision Clinical Modification. (Volumes 1-3), Washington, 
D.C. U.S. Government Printing Office, 1981. 

Public Health Service, National Center for Health Statistics: 
Eighth Revision International Classification of Diseases, 
Adapted for Use in the United States, Vols. 1 and 2. PHS 
Pub. No. 1693. U.S. Government Printing Office, 1968. 

Rafferty, J.: Patterns of hospital use: An analysis of short- 
run variations. Journal of Political Economy 79: 154, 1971. 

Simborg, D.W.: DRG creep: A new hospital-acquired 
disease. The New England Journal of Medicine, 304:26, June 
1981. 

Shin, Y.: Variation of Hospital Cost and Product 
Heterogeneity. Health Insurance Studies Contract Research 
Series (77-11722), Washington, D.C, U.S. Department of 
Health, Education, and Welfare, 1977. 

Shin, Y.: Variation of Hospital Cost and Product 
Heterogeneity — Development Testing and Evaluation of a 
Prospective Reimbursement System. Unpublished Doctoral 
Dissertation, Yale University, 1977. 

Sonquist, J.A., and Morgan, J.N.: The Detection of 
Interaction Effects. Ann Arbor. Institute for Social Research, 
University of Michigan, 1964. 

Theriault, K., Mills, R., and Elia, E.: The AUTOGRP 
Reference Manual. Yale University, Institution for Social 
and Policy Studies, Center for Health Studies, 1979. 

Thompson, J.D., Fetter, R., and Mross, C: Case mix and 
resource use. Inquiry 12: 300, 1975. 

Tukey, T.W.: Exploratory Data Analysis. Addison-Wesley, 
1970. 



127 



Appendix I: Contributors 



129 



ICD-9-CM DRG Steering Committee 

The Steering Committee's charge was to provide to 
the Yale Project Staff comments and 
recommendations on the clinical and technical 
decisions made by Yale Staff in the preparation of the 
new ICD-9-CM Diagnosis-Related Groups. The 
committee met at least once a month to review 
ongoing research activities of the Project Staff. The 
committee was fortunate to have input from many 
interested obsevers who attended our meetings on a 
routine basis. Membership of the Steering Committee 
included the following representatives from 
participating organizations: 

Richard Averill 

Associate Director for Research 
Yale University 

School of Organization & Management 
Health Systems Management Group 

Mark Chassin, M.D. 

Health Standards and Quality Bureau 

Health and Human Services 

Charles DeFuria 
Project Officer 

Office of Demonstration & Evaluation 
Health Care Financing Administration 
Health and Human Services 

Robert B. Fetter 
Professor 
Yale University 

School of Organization & Management and 
Institution for Social and Policy Studies 
Director, Health Systems Management Group, 
School of Organization & Management 

Ann T. Freedman 
Project Director 
Yale University 

School of Organization & Management 
Health Systems Management Group 

John Hughes, M.D. 

Clinical Instructor in Medicine 

Yale University School of Medicine 

Physician Consultant 

Yale University 

School of Organization & Management 
Health Systems Management Group 

Stephen Jencks, M.D. 
Chief, Quality Assurance 
Bureau of Medical Services 
U.S. Public Health Service 

Gail Lasdon 

Former Project Officer 

Office of Research, Demonstrations, and Statistics 
Health Care Financing Administration 
Health and Human Services 



Jeffrey L. Lichtenstein, M.D. 
Senior Research Scientist 
Yale University 

School of Organization & Management 
Health Systems Management Group 
Director of Medical Education/ 
Medical Staff Coordinator 
Meriden-Wallingford Hospital 

Leo Lichtig, 
Project Specialist 

New Jersey State Department of Health 
Case Mix Project 

John Lowe, M.D. 
Physician Consultant 
Commission on Professional and 
Hospital Activities 

Robert L. Mullin, M.D. 

Director, Patient Care Evaluation, 

Attending Surgeon — Cardiothoracic 

Yale-New Haven Hospital 

Assistant Clinical Professor, 

Yale University, School of Medicine, 

Consultant, Yale University 

School of Organization & Management 

Health Systems Management Group 

Warren Nestler, M.D. 
Medical Director 
Overlook Hospital 

Julian Pettengill 
Project Officer 

Office of Research, Demonstrations, and Statistics 
Health Care Financing Administration 
Health and Human Services 

John D. Thompson 
Professor 

Yale University, Department of 
Epidemiology and Public Health 
and Institution for Social and 
Policy Studies 

Chief, Division of Health Services 
Administration and Nursing Administration 

Dale Schumacher, M.D. 
President 

Rockburn Institute 

Associate Director of the Center 

for Hospital Finance and Management 

Johns Hopkins University 

James Vertrees 
Economist 

Office of Research, Demonstrations, and Statistics 
Health Care Financing Administration 
Health and Human Services 



130 



Walter Wood 

Management, Contract and Research Services 
Commission on Professional and 
Hospital Activities 

Richard Yaffe 
Branch Chief 

Health Standards and Quality Bureau 
Health Care Financing Administration 
Health and Human Services 

Clinical Council on Classification 

Review of the clinical coherence of the new DRGs 
was provided by individual members of the Clinical 
Council on Classification. The Clinical Council on 
Classification was responsible for providing both 
clinical and technical decisions in the preparation of 
the International Classification of Diseases, 9th Revision, 
Clinical Modification. It should be noted the Clinical 
Council on Classification was disbanded in 1980 but 
for purposes of this project the name was retained. 
Yale Project Staff along with the Commission on 
Professional and Hospital Activities coordinated the 
work of the Clinical Council. Members included: 

August Colenbrander, M.D. 

American Academy of Ophthalmology and 

Otolaryngology 

Arno Hohn, M.D. 

American Academy of Pediatrics (Chairman) 

Steven Hyler, M.D. 

American Psychiatric Association 

Leonard Kurland, M.D. 
American College of Physicians 

John Lowe, M.D. 

Commission on Professional and Hospital Activities 
Susan Meads 

National Center for Health Statistics 



C. Barber Mueller, M.D. 
American College of Surgeons 

Norman M. Neches, M.D. 

American College of Obstetrics & Gynecologists 

Byron C. Pevehouse, M.D. 

American Association of Neurological Surgeons 

Donald M. Quails, M.D. 

American Academy of Orthopedic Surgeons 

Herbert Sloan, M.D. 

The Society of Thoracic Surgeons 

Richard E. YaDeau, M.D. 
American College of Surgeons 

Commission on Professional and Hospital 
Activities 

The Commission on Professional and Hospital 
Activities had a subcontract with the Health Systems 
Management Group to provide an ICD-9-CM data 
base and to organize the Clinical Council. Additional 
responsibilities included participation in the ICD-9- 
CM Steering Committee. Staff members were: 

Lory Antonucci 
Education Specialist 

Richard P. Ament 
Senior Statistician 

Jan Dreachslin 
Research Scientist 

John Lowe, M.D. 
Physician Consultant 

Linda Snoddon 
Contract Manager 

Walter Wood 

Manager of Research and Statistics 



131 



Commissioner's Physician Advisory 
Committee 

The Commissioner's Physician Advisory Committee 
(CP AC) provides input to the Commissioner of the 
New Jersey State Department of Health on such 
issues as measurement of quality of care and uses for 
diagnosis-related groups. The CP AC was augmented 
by the addition of numerous clinical specialists in 
order to review the ICD-9-CM DRGs as they were 
being developed. This group represented all major 
specialties, and the DRGs for each organ system 
were reviewed by a small group of appropriate 
specialists. 

The members of the CP AC and all others who helped 
with the clinical review of the ICD-9-CM DRGs are 
listed below: 



NAME 

* Louis Albright, M.D. 
Michael Alpert, M.D. 
Harold Bennett, M.D. 
F. C. Braun, M.D. 

Dorothy Bryan, M.D. 
Edward Carden, M.D. 
Robert Cottone, M.D. 
James Cowen, M.D. 
Victor Daibo, M.D. 
Robert Davies, M.D. 

* Charles Dooley, M.D. 

* William Dwyer, M.D. 
Robert Eisinger, M.D. 
Mark Feierstein, M.D. 
R. Fernand, M.D. 
Karen Filkens, M.D. 

* Joanne E. Finley, M.D., 
M.P.H. 

Richard Fong, M.D. 

* Charles Gibbs, M.D. 
A. S. Glushakow, M.D. 
Mark Gold, M.D. 
Robert Gross, M.D. 

Ki Hann, M.D. 

John Hanagan, M.D. 
I. H. Jacobs, M.D. 
Lester Kalisher, M.D. 
Ann Koons, M.D. 

* Bernard Koven, M.D. 
Jack Krenens, M.D. 
Theodore Leibman, M.D. 
Samuel Lichtig, M.D. 
Henry R. Liss, M.D. 

* Nelson Manowitz, M.D. 
Steven Marcus, M.D. 
Arthur McLellan, M.D. 
Matthew Menken, M.D. 
Carl Mercurio, M.D. 



SPECIALTY 
Cardiology 
Psychiatry 
Orthopedics 
Hematology/Oncology, 

Pediatrics 
Pediatrics 
Drug Abuse 
Urology 
Psychiatry 
Orthopedics 
Psychiatry 
Endocrinology 
General Surgery 
Nephrologist 
Orthopedic Surgery 
Orthopedics 
Obstetrics/Gynecology 

Pediatrics 

Orthopedics 

Family Practice 

Orthopedics 

Psychiatry 

Radiology 

Otolaryngology-Hand & 

Neck Surgery 
Medical Oncology 
Opthalmology 
Diagnostic Radiology 
Hematology 
Oncology 
Psychiatry 

Obstetrics/Gynecology 

Obstetrics/Gynecology 

Neuro-Surgery 

General Surgery 

Poisons 

Alcoholism 

Neurology 

Orthopedics 



Andrew Miller, M.D. 
Anthony Minifor, M.D. 
Ben Mojica, M.D. 

S. Nahla, M.D. 
William Nevill, M.D. 
Pudchong Nil, M.D. 

* Warren Nestler, M.D. 
Michael Novogroder, M.D. 

* Daniel O'Regan, M.D. 
Irwin N. Perr, M.D. 
David Plotkin, D.P.M. 
Milton Prytowsky, M.D. 
Michael Rabin, D.O. 

* Richard Rapkin, M.D. 
S. Raz, M.D. 

* Malcolm Schwartz, D.O. 

* Myron Shapiro, M.D. 
Milton Smith, M.D. 

* Catherine Spears, M.D. 
Beril Staffers, M.D. 

S. J. Stefanelli, M.D. 
Laurence Stein, M.D. 
Shyan Syn, M.D. 
Michael Sutula, D.O. 
Jim Thompson, M.D. 

* Felix Vann, M.D. 
E. Washington, M.D. 

* Leah Ziskin, M.D. 

Louise Hansen, RN. 
Francis Quinless, R.N., 
Ph.D. 

Marcia Stachyra, R.N., 

Ph.D. 
Ruth Teip, R.N. 
Joan Tower, R.N. 
Rosanne Wille, R.N., Ph.D. 
Karyn Young, R.N. 
Sara Dogan, R.R.A. 
Joan Loughran, R.R.A. 
Barbara Moore, R.R.A. 
Ruth Paine, R.R.A. 
John Pilek, R.R.A. 
Georgette Siegel, R.R.A. 
Sally Simons, R.R.A. 
Margaret Smith, R.R.A. 
Diane Susalis, R.R.A. 

Larry Eitel, M.P.A., MA. 

Faith K. Goldschmidt, 
M.A., M.P.H. 

Jone M. Kinney, M.A., 
A.B.D. 

Leo K. Lichtig, Ph.D. 



Public Health 

Infectious Disease-Pediatrics 
Infectious Desease-Public 

Health 
Orthopedics 

Thoracic/V ascular Surgery 

Endocrinology 

Internal Medicine 

Pediatric Endocrinology 

Orthopedics 

Psychiatry 

Podiatry 

Pediatric Cardiology 
Family Practice 
Pediatrics 

Otolaryngology-Head & 

Neck Surgery 
Pediatrics 
Otolaryngology 
Orthopedics 
Pediatric Neurology 
Orthopedic Surgery 
Orthopedics 
Gastroenterology 
Perinatology 
Rahabilitation Medicine 
Obstetrics/Gynecology 
Obstetrics/Gynecology 
Orthopedics 
Pediatrics 

Otolaryngology 

Cardiovascular Nursing 

Psychiatric Nursing 
Rehabilitation Nursing 
Infection Control 
Neurosurgical Nursing 
Infection Control 
Medical Records 
Medical Records 
Medical Records 
Medical Records 
Medical Records 
Medical Records 
Medical Records 
Medical Records 
Medical Records 

Health Economics Research 
Specialist 

Health Economics Research 
Specialist 

Health Economics Research 

Specialist 
Project Specialist 



* Member of the Commissioner's Physician Advisory Committee. 



132 



Hospital Care Subcommittee 

The Hospital Care Subcommittee of the Technical 
Advisory Committee on Health Data provides input 
to the Department of Health, for the State of New 
Jersey on such issues as data quality, utilization of 
discharge abstracts, and other hospital data concerns. 
It is composed of medical record professionals, 
representatives from payor organizations, physician 
review organizations, and the Department as follows: 

Melvin Andrews, M.D. — West Jersey Hospital 
Systems; 

Sonja Bennett, R.R.A. — Riverview Hospital; 
Estelle Butler, A.R.T. — New Jersey Department of 

Health, Health Data Services; 
Donna Dawson — New Jersey Department of Health, 

DRG Project; 
James Fitzpatrick, MD. — Paul Kimball Hospital; 
Faith Goldschmidt, M.A, M.P.H. — New Jersey 



Department of Health, DRG Project; 
Charles Grubin, M.D. — New Jersey Medicaid; 
Lisa Kennedy — Essex County, PSRO; 
Tom Kryzak— HSA, 1; 

Leo Lichtig, Ph.D. — New Jersey Department of 

Health, DRG Project; 
Joan Loughran, R.R.A. — Medical Center at 

Princeton; 

Barbara Moore, R.R.A. — New Jersey Utilization 

Program, Center for Health Affairs; 
Jack Nuneville — New Jersey Department of Health, 

Health Data Services; 
Ruth Paine, R.R.A. — Blue Cross of New Jersey; 
Georgette Siegel, A.R.T. — St. Clare's Hospital; 
Rose Marie Sked — New Jersey Medicaid; 
Margaret Smith, R.R.A. — Mountainside Hospital; 
Diane Susalis, R.R.A. — Hunterdon Medical Center; 
Dave Weiner— PSRO Union County; 
Theda Wasserman — New Jersey Medicaid; and 
S. E. Yliano, M.D. — New Jersey Medicaid. 



133 



Appendix II: Summary tables of 
diagnosis-related groups and major 
diagnostic group tree diagrams 

This section contains descriptive information 
regarding the structure and the content of the new 
ICD-9-CM Diagnosis-Related Groups. Specifically, 
for each major diagnostic category (MDC), the 
material includes: 

• Tree diagrams illustrating how patients with a 
principal diagnosis in that MDC are classified into 
specific DRGs. 

• Key to symbols used in the tree diagrams. 

• Abbreviated definitions of DRGs. 

Ungroupable records 

Three groups have been developed to describe a 
reason(s) a patient abstract is not assigned to one of 



the 467 DRGs. These three groups have DRG 
numbers attached to them for convenience, but they 
do not represent a DRG in the traditional sense and 
should not be used as such. 

DRG and definition 

468 — Unrelated operating room procedure to a given 

major diagnostic category 

469 — Valid Diagnosis but not as a principal diagnosis 

470 — Invalid: age; sex; diagnosis; ECode; discharge 

status; the record does not meet the 
criteria for any DRG in the MDC 
indicated by the principal diagnosis (this 
last condition is unlikely to occur). 



419-177 O - 84 — 10 



135 



REVISED ICD-9-CM DIAGNOSIS RELATED GROUPS 



001. 


MDC 


01P, 


002 


MDC 


01P, 


003 


MDC 


01P, 


004 


MDC 


01P, 


005 


,MDC 


01P, 


006 


MDC 


01P, 


007. 


MDC 


01P, 


008 


MDC 


01P, 


009 


MDC 


01M, 


010 


MDC 


01M, 


Oil 


MDC 


01M, 


012 


MDC 


01M, 


013 


MDC 


01M, 


014 


,MDC 


01M, 


015 


,MDC 


01M, 


016 


,MDC 


01M, 


017 


,MDC 


01M, 


018 


,MDC 


01M, 


019 


,MDC 


01M, 


020 


,MDC 


01M, 


021 


,MDC 


01M, 


022 


,MDC 


01M, 


023 


,MDC 


01M, 


024 


,MDC 


01M, 


025 


,MDC 


01M, 


026 


,MDC 


01M, 


027 


,MDC 


01M, 


028 


,MDC 


01M, 


029 


,MDC 


01M, 


030 


,MDC 


01M, 


031 


,MDC 


01M, 


032 


,MDC 


01M, 


033 


,MDC 


01M, 


034 


,MDC 


01M, 


035 


,MDC 


01M, 


036 


,MDC 


02P. 


037 


,MDC 


02P 


038 


,MDC 


02P. 


039 


,MDC 


02P. 


040 


,MDC 


02P 


041 


,MDC 


02P 


042 


,MDC 


02P 


043 


,MDC 


02M 


044 


,MDC 


02M 


045 


,MDC 


02M 


046 


,MDC 


02M 


047 


,MDC 


02M 


048 


,MDC 


02M 


049 


,MDC 


03P 


050 


,MDC 


03P 


051 


,MDC 


03P 


052 


,MDC 


03P 



CRANIOTOMY AGE >=18 EXCEPT FOR TRAUMA 

CRANIOTOMY FOR TRAUMA AGE >=18 

CRANIOTOMY AGE <18 

SPINAL PROCEDURES 

EXTRACRANIAL VASCULAR PROCEDURES 

CARPAL TUNNEL RELEASE 

PERIPH & CRANIAL NERVE & OTHER NERV SYST PROC AGE >=70 &/0R C.I 
PERIPH & CRANIAL NERVE & OTHER NERV SYST PROC AGE <70 W/0 C.C. 
SPINAL DISORDERS & INJURIES 

NERVOUS SYSTEM NEOPLASMS AGE >=70 AND/OR C.C. 
NERVOUS SYSTEM NEOPLASMS AGE <70 W/0 C.C. 
DEGENERATIVE NERVOUS SYSTEM DISORDERS 
MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA 
SPECIFIC CEREBROVASCULAR DISORDERS EXCEPT TIA 
TRANSIENT ISCHEMIC ATTACKS 

NONSPECIFIC CEREBROVASCULAR DISORDERS WITH C.C. 

NONSPECIFIC CEREBROVASCULAR DISORDERS W/0 C.C. 

CRANIAL & PERIPHERAL NERVE DISORDERS AGE >=70 AND/OR C.C. 

CRANIAL & PERIPHERAL NERVE DISORDERS AGE <70 W/0 C.C. 

NERVOUS SYSTEM INFECTION EXCEPT VIRAL MENINGITIS 

VIRAL MENINGITIS 

HYPERTENSIVE ENCEPHALOPATHY 

NONTRAUMATIC STUPOR & COMA 

SEIZURE & HEADACHE AGE >=70 AND/OR C.C. 

HEADACHE AGE 18-69 W/0 C.C. 
HEADACHE AGE 0-17 

COMA, COMA >1 HR 

COMA, COMA <1 HR AGE >=70 AND/OR C.C. 
COMA <1 HR AGE 18-69 W/0 C.C. 
COMA <1 HR AGE 0-17 
C.C. 
C. 



SEIZURE & 
SEIZURE & 
TRAUMATIC STUPOR & 
TRAUMATIC STUPOR & 
TRAUMATIC STUPOR & 
TRAUMATIC STUPOR & 



CONCUSSION AGE >=70 AND /OR 
CONCUSSION AGE 18-69 W/0 C, 
CONCUSSION AGE 0-17 

OTHER DISORDERS OF NERVOUS SYSTEM AGE >=70 AND/OR 
OTHER DISORDERS OF NERVOUS SYSTEM AGE <70 W/0 C.C. 

RETINAL PROCEDURES 
ORBITAL PROCEDURES 
PRIMARY IRIS PROCEDURES 
LENS PROCEDURES 

EXTRAOCULAR PROCEDURES EXCEPT ORBIT AGE >=18 
EXTRAOCULAR PROCEDURES EXCEPT ORBIT AGE 0-17 
INTRAOCULAR PROCEDURES EXCEPT RETINA, IRIS & LENS 
HYPHEMA 

ACUTE MAJOR EYE INFECTIONS 
NEUROLOGICAL EYE DISORDERS 

OTHER DISORDERS OF THE EYE AGE >=18 WITH C.C. 
OTHER DISORDERS OF THE EYE AGE >=18 W/0 C.C. 
OTHER DISORDERS OF THE EYE AGE 0-17 

MAJOR HEAD & NECK PROCEDURES 
SIALOADENECTOMY 

SALIVARY GLAND PROCEDURES EXCEPT SIALOADENECTOMY 
CLEFT LIP & PALATE REPAIR 



C.C 



136 



REVISED ICD-9-CM DIAGNOSIS RELATED GROUPS 



053 


MDC 


03P , 


054 j 


MDC 


03P , 


055 j 


MDC 


03P , 


056 


MDC 


03P , 


057 


MDC 


03P , 


058 


MDC 


03P , 


059 


MDC 


03P , 


060 


MDC 


03P , 


061 


MDC 


03P, 


062 


MDC 


03P, 


063 


MDC 


03P, 


064 : 


MDC 


03M, 


065 


MDC 


03M, 


066 


MDC 


03M , 


067 


MDC 


03M , 


068 , 


MDC 


03M , 


069 


MDC 


03M, 


070 , 


MDC 


03M, 


071, 


MDC 


03M, 


072 


MDC 


03M, 


073 


MDC 


03M , 


074 


MDC 


03M, 


075 


MDC 


04P , 


076 


MDC 


04P , 


077 


MDC 


04P , 


078 


MDC 


04M, 


079 


MDC 


04M , 


080 


MDC 


04M, 


081 


MDC 


04M, 


082 


,MDC 


04M , 


083 


,MDC 


04M, 


084 


,MDC 


04M , 


085 


,MDC 


04M, 


086 


,MDC 


04M , 


087 


,MDC 


04M, 


088 


,MDC 


04M , 


089 


,MDC 


04M , 


090 


,MDC 


04M , 


091 


,MDC 


04M, 


092 


,MDC 


04M, 


093 


,MDC 


04M, 


094 


,MDC 


04M 


095 


,MDC 


04M 


096 


,MDC 


04M 


097 


,MDC 


04M 


098 


,MDC 


04M 


099 


,MDC 


04M 


100 


,MDC 


04M 


101 


,MDC 


04M 


102 


,MDC 


04M 


103 


,MDC 


05P 


104 


,MDC 


05P 



URI AGE >=70 AND/OR C 
URI AGE 18-69 W/O C.C 
URI AGE 0-17 



SINUS & MASTOID PROCEDURES AGE >=18 
SINUS & MASTOID PROCEDURES AGE 0-17 
MISCELLANEOUS EAR, NOSE & THROAT PROCEDURES 
RHINOPLASTY 

T&A PROC EXCEPT TONSILLECTOMY &/OR ADENOIDECTOMY AGE >=18 
T&A PROC EXCEPT TONSILLECTOMY &/OR ADENOIDECTOMY AGE 0-17 
TONSILLECTOMY AND/OR ADENOIDECTOMY ONLY , AGE >=18 
TONSILLECTOMY AND/OR ADENOIDECTOMY ONLY, AGE 0-17 
MYRINGOTOMY AGE >=18 
MYRINGOTOMY AGE 0-17 

OTHER EAR, NOSE & THROAT O.R. PROCEDURES 
EAR, NOSE & THROAT MALIGNANCY 
DYSEQUILIBRIUM 
EPISTAXIS 
EPIGLOTTITIS 
OTITIS MEDIA 
OTITIS MEDIA 
OTITIS MEDIA 
LARYNGOTRACHEITIS 
NASAL TRAUMA & DEFORMITY 

OTHER EAR, NOSE & THROAT DIAGNOSES AGE >=18 
OTHER EAR, NOSE & THROAT DIAGNOSES AGE 0-1/ 

MAJOR CHEST PROCEDURES 

O.R. PROC ON THE RESP SYSTEM EXCEPT MAJOR CHEST WITH C.C. 
O.R. PROC ON THE RESP SYSTEM EXCEPT MAJOR CHEST W/O C.C. 
PULMONARY EMBOLISM 

RESPIRATORY INFECTIONS & INFLAMMATIONS AGE >=70 AND/OR C.C 
RESPIRATORY INFECTIONS & INFLAMMATIONS AGE 18-69 W/O C.C. 
RESPIRATORY INFECTIONS & INFLAMMATIONS AGE 0-17 
RESPIRATORY NEOPLASMS 

MAJOR CHEST TRAUMA AGE >=70 AND/OR C.C. 
MAJOR CHEST TRAUMA AGE <70 W/O C.C. 
PLEURAL EFFUSION AGE >=70 AND/OR C.C. 
PLEURAL EFFUSION AGE <70 W/O C.C. 
PULMONARY EDEMA & RESPIRATORY FAILURE 
CHRONIC OBSTRUCTIVE PULMONARY DISEASE 
SIMPLE PNEUMONIA & PLEURISY AGE >=70 AND/OR C.C. 
SIMPLE PNEUMONIA & PLEURISY AGE 18-69 W/O C.C. 
SIMPLE PNEUMONIA & PLEURISY AGE 0-17 
INTERSTITIAL LUNG DISEASE AGE >=70 AND/OR C.C. 
INTERSTITIAL LUNG DISEASE AGE <70 W/O C.C. 
PNEUMOTHORAX AGE >=70 AND/OR C.C. 
PNEUMOTHORAX AGE <70 W/O C.C. 
BRONCHITIS & ASTHMA AGE >=70 AND/OR C.C. 
BRONCHITIS & ASTHMA AGE 18-69 W/O C.C. 
BRONCHITIS & ASTHMA AGE 0-17 

RESPIRATORY SIGNS & SYMPTOMS AGE >=70 AND/OR C.C. 
RESPIRATORY SIGNS & SYMPTOMS AGE <70 W/O C.C. 
OTHER RESPIRATORY DIAGNOSES AGE >=70 AND/OR C.C. 
OTHER RESPIRATORY DIAGNOSES AGE <70 

HEART TRANSPLANT 

CARDIAC VALVE PROCEDURE WITH PUMP & WITH CARDIAC CATH 



REVISED ICD-9-CM DIAGNOSIS RELATED GROUPS 



105 


,MDC 


05P 


106 


,MDC 


05P 


107 


,MDC 


05P 


108 


,MDC 


05P 


109 


,MDC 


05P 


110 


,MDC 


05P 


111 


,MDC 


05P 


112 


,MDC 


05P 


113 


,MDC 


05P 


114 


,MDC 


05P 


115 


,MDC 


05P 


116 


,MDC 


05P 


117 


,MDC 


05P 


118 


,MDC 


05P 


119 


,MDC 


05P 


120 


,MDC 


05P 


121 


,MDC 


05M 


122 


,MDC 


05M 


123 


,MDC 


05M 


124 


,MDC 


05M 


125 


,MDC 


05M 


126 


,MDC 


05M 


127 


,MDC 


05M 


128 


,MDC 


05M 


129 


,MDC 


05M 


130 


,MDC 


05M 


131 


,MDC 


05M 


132 


,MDC 


05M 


133 


,MDC 


05M 


134 


,MDC 


05M 


135 


,MDC 


05M 


136 


,MDC 


05M 


137 


,MDC 


05M 


138 


,MDC 


05M 


139 


,MDC 


05M 


140 


,MDC 


05M 


141 


,MDC 


05M 


142 


,MDC 


05M 


143 


,MDC 


05M 


144 


,MDC 


05M 


145 


,MDC 


05M 


146 


,MDC 


06P 


147 


,MDC 


06P 


148 


,MDC 


06P 


149 


,MDC 


06P 


150 


,MDC 


06P 


151 


,MDC 


06P 


152 


,MDC 


06P 


153 


,MDC 


06P 


154 


,MDC 


06P 


155 


,MDC 


06P 


156 


,MDC 


06P 


157 


,MDC 


06P 



CARDIAC VALVE PROCEDURE WITH PUMP & W/O CARDIAC CATH 
CORONARY BYPASS WITH CARDIAC CATH 
CORONARY BYPASS W/O CARDIAC CATH 

CARDIOTHOR PROC, EXCEPT VALVE & CORONARY BYPASS, WITH PUMP 
CARDIOTHORACIC PROCEDURES W/O PUMP 

MAJOR RECONSTRUCTIVE VASCULAR PROCEDURES AGE >=70 AND /OR C.C. 
MAJOR RECONSTRUCTIVE VASCULAR PROCEDURES AGE <70 W/O C.C. 
VASCULAR PROCEDURES EXCEPT MAJOR RECONSTRUCTION 
AMPUTATION FOR CIRC SYSTEM DISORDERS EXCEPT UPPER LIMB & TOE 
UPPER LIMB & TOE AMPUTATION FOR CIRC SYSTEM DISORDERS 
PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI OR CHF 
PERMANENT CARDIAC PACEMAKER IMPLANT W/O AMI OR CHF 
CARDIAC PACEMAKER REPLACE & REVIS EXC PULSE GEN REPL ONLY 
CARDIAC PACEMAKER PULSE GENERATOR REPLACEMENT ONLY 
VEIN LIGATION & STRIPPING 

OTHER O.R. PROCEDURES ON THE CIRCULATORY SYSTEM 
CIRCULATORY DISORDERS WITH AMI & C.V. COMP. DISCH. ALIVE 
CIRCULATORY DISORDERS WITH AMI W/O C.V. COMP. DISCH. ALIVE 
CIRCULATORY DISORDERS WITH AMI, EXPIRED 

CIRCULATORY DISORDERS EXC AMI, WITH CARD CATH & COMPLEX DIAG 
CIRCULATORY DISORDERS EXC AMI, WITH CARD CATH W/O COMPLEX DIAG 
ACUTE & SUBACUTE ENDOCARDITIS 
HEART FAILURE & SHOCK 
DEEP VEIN THROMBOPHLEBITIS 
CARDIAC ARREST 

PERIPHERAL VASCULAR DISORDERS AGE >=70 AND/OR C.C. 
PERIPHERAL VASCULAR DISORDERS AGE <70 W/O C.C. 
ATHEROSCLEROSIS AGE >=70 AND/OR C.C. 
ATHEROSCLEROSIS AGE <70 W/O C.C. 
HYPERTENSION 

VALVULAR DISORDERS AGE 
VALVULAR DISORDERS AGE 
VALVULAR DISORDERS AGE 0-17 
CONDUCTION DISORDERS AGE >=70 AND/OR C.C 
CONDUCTION DISORDERS AGE <70 W/O C.C. 



>=70 AND/OR 
18-69 W/O C. 



CARDIAC CONGENITAL 
CARDIAC CONGENITAL 
CARDIAC CONGENITAL 
CARDIAC ARRHYTHMIA 
CARDIAC ARRHYTHMIA 
ANGINA PECTORIS 

SYNCOPE & COLLAPSE AGE >=70 AND/OR C.C 
SYNCOPE & COLLAPSE AGE <70 W/O C.C. 
CHEST PAIN 

OTHER CIRCULATORY DIAGNOSES WITH C.C. 
OTHER CIRCULATORY DIAGNOSES W/O C.C. 



RECTAL RESECTION AGE >=70 AND/OR C.C. 
RECTAL RESECTION AGE <70 W/O C.C. 

MAJOR SMALL & LARGE BOWEL PROCEDURES AGE >=70 AND/OR C.C. 
MAJOR SMALL & LARGE BOWEL PROCEDURES AGE <70 W/O C.C. 
PERITONEAL ADHESIOLYSIS AGE >=70 AND/OR C.C. 
PERITONEAL ADHESIOLYSIS AGE <70 W/O C.C. 

MINOR SMALL & LARGE BOWEL PROCEDURES AGE >=70 AND/OR C.C. 
MINOR SMALL & LARGE BOWEL PROCEDURES AGE <70 W/O C.C. 
STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES AGE >=70 AND/OR 
STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES AGE 18-69 W/O C, 
STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES AGE 0-17 
ANAL PROCEDURES AGE >=70 AND/OR C.C. 



138 



REVISED ICD-9-CM DIAGNOSIS RELATED GROUPS 



158 


,MDC 


06P 


159 


,MDC 


06P 


160 


,MDC 


06P 


161 


,MDC 


06P 


162 


,MDC 


06P 


163 


,MDC 


06P 


164 


,MDC 


06P 


165 


,MDC 


06P 


166 


,MDC 


06P 


167 


,MDC 


06P 


168 


,MDC 


06P 


169 


,MDC 


06P 


170 


,MDC 


06P 


171 


,MDC 


06P 


172 


,MDC 


06M 


173 


,MDC 


06M 


174 


,MDC 


06M 


175 


,MDC 


06M 


176 


,MDC 


06M 


177 


,MDC 


06M 


178 


,MDC 


06M 


179 


,MDC 


06M 


180 


,MDC 


06M 


181 


,MDG 


06M 


182 


,MDC 


06M 


183 


,MDC 


06M 


184 


,MDC 


06M 


185 


,MDC 


06M 


186 


,MDC 


06M 


187 


,MDC 


06M 


188 


,MDC 


06M 


189 


,MDC 


06M 


190 


,MDC 


06M 


191 


,MDC 


07P 


192 


,MDC 


07P 


193 


,MDC 


07P 


194 


,MDC 


07P 


195 


,MDC 


07P 


196 


,MDC 


07P 


197 


,MDC 


07P 


198 


,MDC 


07P 


199 


,MDC 


07P 


200 


,MDC 


07P 


201 


,MDC 


07P 


202 


,MDC 


07M 


203 


,MDC 


07M 


204 


,MDC 


07M 


205 


MDC 


07M 


206 


,MDC 


07M 


207 


,MDC 


07M 


208 


,MDC 


07M 


209 ,MDC 


08P 



c.c. 



ANAL PROCEDURES AGE <70 W/O C.C. 

HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL AGE >=70 AND/OR C 
HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL AGE 18-69 W/O C.C 
INGUINAL & FEMORAL HERNIA PROCEDURES AGE >=70 AND/OR C.C. 
INGUINAL & FEMORAL HERNIA PROCEDURES AGE 18-69 W/O C.C. 
HERNIA PROCEDURES AGE 0-17 

APPENDECTOMY WITH COMPLICATED PRINC. DIAG AGE>=70 AND/OR C.C. 
APPENDECTOMY WITH COMPLICATED PRINC. DIAG AGE <70 W/O C.C. 
APPENDECTOMY W/O COMPLICATED PRINC. DIAG AGE >=70 AND/OR C.C. 
APPENDECTOMY W/O COMPLICATED PRINC. DIAG AGE <70 W/O C.C. 
PROCEDURES ON THE MOUTH AGE >=70 AND/OR C.C. 
PROCEDURES ON THE MOUTH AGE <70 W/O C.C. 
OTHER DIGESTIVE SYSTEM PROCEDURES AGE >=70 AND/OR C.C. 
OTHER DIGESTIVE SYSTEM PROCEDURES AGE <70 W/O C.C. 
DIGESTIVE MALIGNANCY AGE >=70 AND/OR C.C. 
DIGESTIVE MALIGNANCY AGE <70 W/O C.C. 
G.I. HEMORRHAGE AGE >=70 AND/OR C.C. 
G.I. HEMORRHAGE AGE <70 W/O C.C. 
COMPLICATED PEPTIC ULCER 
UNCOMPLICATED PEPTIC ULCER >=70 AND/OR 
UNCOMPLICATED PEPTIC ULCER <70 W/O C.C 
INFLAMMATORY BOWEL DISEASE 
G.I. OBSTRUCTION AGE >=70 AND/OR C.C. 
G.I. OBSTRUCTION AGE <70 W/O C.C. 
ESOPHAGITIS .GASTROENT .& MISC. DIGEST 
ESOPHAGITIS ,GASTROENT .& MISC. DIGEST 
ESOPHAGITIS, GASTROENTERITIS & MISC. 
DENTAL & ORAL DIS. EXC EXTRACTIONS & 
DENTAL & ORAL DIS. EXC EXTRACTIONS & 
DENTAL EXTRACTIONS & RESTORATIONS 

OTHER DIGESTIVE SYSTEM DIAGNOSES AGE >=70 AND/OR C.C. 
OTHER DIGESTIVE SYSTEM DIAGNOSES AGE 18-69 W/O C.C. 
OTHER DIGESTIVE SYSTEM DIAGNOSES AGE 0-17 

MAJOR PANCREAS, LIVER & SHUNT PROCEDURES 
MINOR PANCREAS, LIVER & SHUNT PROCEDURES 

BILIARY TRACT PROC EXC TOT CHOLECYSTECTOMY AGE >=70 &/0R C.C. 
BILIARY TRACT PROC EXC TOT CHOLECYSTECTOMY AGE <70 W/O C.C. 
TOTAL CHOLECYSTECTOMY WITH C.D.E. AGE >=70 AND/OR C.C. 
TOTAL CHOLECYSTECTOMY WITH C.D.E. AGE <70 W/O C.C. 
TOTAL CHOLECYSTECTOMY W/O C.D.E. AGE >=70 AND/OR C.C. 
TOTAL CHOLECYSTECTOMY W/O C.D.E. AGE <70 W/O C.C. 
HEPATOBILIARY DIAGNOSTIC PROCEDURE FOR MALIGNANCY 
HEPATOBILIARY DIAGNOSTIC PROCEDURE FOR NON-MALIGNANCY 
OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES 
CIRRHOSIS & ALCOHOLIC HEPATITIS 
MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS 
DISORDERS OF PANCREAS EXCEPT MALIGNANCY 

DISORDERS OF LIVER EXC MALIG,CIRR ,ALC HE PA AGE >=70 AND/OR C.C 
DISORDERS OF LIVER EXC MALIG ,CIRR ,ALC HEPA AGE <70 W/O C.C. 
DISORDERS OF THE BILIARY TRACT AGE >=70 AND/OR C.C. 
DISORDERS OF THE BILIARY TRACT AGE <70 W/O C.C. 



. DIS AGE >=70 &/0R C.C. 

, DIS AGE 18-69 W/O C.C. 
DIGEST. DISORDERS AGE 
RESTORATIONS, AGE >=18 
RESTORATIONS, AGE 0-17 



17 



REVISED ICD-9-CM DIAGNOSIS RELATED GROUPS 



210 


,MDC 


08P 


211 


,MDC 


08P 


212 


MDC 


BP 


213 


MDC 


08P 


214 


,MDC 


08P 


215 


,MDC 


08P 


216 


,MDC 


08P 


217 


P MDC 


08P 


218 


MDC 


08P 


219 


,MDC 


08P 


220 


,MDC 


08P 


221 


,MDC 


08P 


222 


,MDC 


08P 


223 


,MDC 


08P 


224 


,MDC 


08P 


225 


,MDC 


08P 


226 


,MDC 


08P 


227 


,MDC 


08P 


228 


,MDC 


08P 


229 


,MDC 


08P 


230 


,MDC 


08P 


231 


,MDC 


08P 


232 


,MDC 


08P 


233 


,MDC 


08P 


234 


,MDC 


08P 


235 


,MDC 


08M 


236 


,MDC 


08M 


237 


,MDC 


08M 


238 


,MDC 


08M 


239 


,MDC 


08M 


240 


,MDC 


08M 


241 


( MDC 


08M 


242 


,MDC 


08M 


243 


,MDC 


08M 


244 


,MDC 


08M 


245 


,MDC 


08M 


246 


,MDC 


08M 


247 


,MDC 


08M 


248 


,MDC 


08M 


249 


,MDC 


08M 


250 


,MDC 


08M 


251 


,MDC 


08M 


252 


,MDC 


08M 


253 


,MDC 


08M 


254 


,MDC 


08M 


255 


,MDC 


08M 


256 


,MDC 


08M 


257 


,MDC 


09P 


258 


,MDC 


09P 


259 


,MDC 


09P 


260 


,MDC 


09P 


261 


,MDC 


09P 


262 


,MDC 


09P 



HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >=70 AND/OR C.C. 

HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE 18-69 W/O C.C. 

HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE 0-17 

AMPUTATIONS FOR MUSCULOSKELETAL SYSTEM & CONN. TISSUE DISORDERS 

BACK & NECK PROCEDURES AGE >=70 AND/OR C.C. 

BACK & NECK PROCEDURES AGE <70 W/O C.C. 

BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE 

WND DEBRID & SKN GRFT EXC HAND, FOR MUSCSKELETAL & CONN.TISS .DIS 

LOWER EXTREM & HUMER PROC EXC HIP , FOOT , FEMUR AGE >=70 &/OR C.C. 

LOWER EXTREM & HUMER PROC EXC HIP , FOOT , FEMUR AGE 18-69 W/O C.C. 

LOWER EXTREM & HUMER PROC EXC HIP , FOOT , FEMUR AGE 0-17 

KNEE PROCEDURES AGE >=70 AND/OR C.C. 

KNEE PROCEDURES AGE <70 W/O C.C. 

UPPER EXTREMITY PROC EXC HUMERUS & HAND AGE >=70 AND/OR C.C. 
UPPER EXTREMITY PROC EXC HUMERUS & HAND AGE <70 W/O C.C. 
FOOT PROCEDURES 

SOFT TISSUE PROCEDURES AGE >=70 AND/OR C.C. 
SOFT TISSUE PROCEDURES AGE <70 W/O C.C. 
GANGLION (HAND) PROCEDURES 
HAND PROCEDURES EXCEPT GANGLION 

LOCAL EXCISION & REMOVAL OF INT FIX DEVICES OF HIP & FEMUR 
LOCAL EXCISION & REMOVAL OF INT FIX DEVICES' EXCEPT HIP & FEMUR 
ARTHROSCOPY 

OTHER MUSCULOSKELET SYS & CONN TISS O.R. 
OTHER MUSCULOSKELET SYS & CONN TISS O.R. 
FRACTURES OF FEMUR 
FRACTURES OF HIP & PELVIS 
SPRAINS, STRAINS, & DISLOCATIONS OF HIP, 
OSTEOMYELITIS 

PATHOLOGICAL FRACTURES & MUSCULOSKELETAL 
CONNECTIVE TISSUE DISORDERS AGE >=70 AND/OR C 
CONNECTIVE TISSUE DISORDERS AGE <70 W/O C.C. 
SEPTIC ARTHRITIS 
MEDICAL BACK PROBLEMS 

BONE DISEASES & SEPTIC ARTHROPATHY AGE >=70 AND/OR C.C. 
BONE DISEASES & SEPTIC ARTHROPATHY AGE <70 W/O C.C. 
NON-SPECIFIC ARTHROPATHIES 

SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE 
TENDONITIS, MYOSITIS & BURSITIS 

AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE 
FX,SPRNS,STRNS & DISL OF FOREARM , HAND , FOOT AGE >=70 &/OR C.C. 

& DISL OF FOREARM, HAND, FOOT AGE 18-69 W/O C.C. 
& DISL OF FORE ARM, HAND, FOOT AGE 0-17 
& DISL OF UPARM,LOWLEG EX FOOT AGE >=70 &/OR C.C 
& DISL OF UPARM,LOWLEG EX FOOT AGE 18-69 W/O C.C 
& DISL OF UPARM,LOWLEG EX FOOT AGE 0-17 



PROC AGE >=70 &/OR C.C 
PROC AGE <70 W/O C.C. 



PELVIS & THIGH 

& CONN. TISS. MALIGNANCY 
C. 



FX,SPRNS,STRNS 
FX,SPRNS,STRNS 
FX,SPRNS,STRNS 
FX,SPRNS,STRNS 
FX,SPRNS,STRNS 



OTHER DIAGNOSES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE 

TOTAL MASTECTOMY FOR MALIGNANCY AGE >=70 AND/OR C.C. 
TOTAL MASTECTOMY FOR MALIGNANCY AGE <70 W/O C.C. 
SUBTOTAL MASTECTOMY FOR MALIGNANCY AGE >=70 AND/OR C.C. 
SUBTOTAL MASTECTOMY FOR MALIGNANCY AGE <70 
BREAST PROC FOR NON-MALIG EXCEPT BIOPSY & LOC EXC 
BREAST BIOPSY & LOCAL EXCISION FOR NON-MALIGNANCY 



140 



REVISED ICD-9-CM DIAGNOSIS RELATED GROUPS 



263, 


MDC 


09P 


264, 


MDC 


09P 


265, 


MDC 


09P 


266, 


MDC 


09P 


267, 


MDC 


09P 


268, 


MDC 


09P 


269, 


MDC 


09P 


270, 


MDC 


09P 


271, 


MDC 


09M 


272, 


MDC 


09M 


273, 


MDC 


09M 


274, 


MDC 


09M 


275, 


MDC 


09M 


276, 


MDC 


09M 


277, 


MDC 


09M 


278, 


MDC 


09M 


279, 


MDC 


09M 


280, 


MDC 


09M 


£m \J JL 


Mnr 


\J J i 1 


282 


MDC 


09M 


283, 


MDC 


09M 


284, 


MDC 


09M 


285 


MDC 


10P 


286 


MDC 


10P 


287 


MDC 


10P 


288 


MDC 


10P 


289 


,MDC 


10P 


290 


MDC 


10P 


291 


,MDC 


10P 


292 


MDC 


10P 


293 


,MDC 


10P 


294 


,MDC 


10M 


295 


,MDC 


10M 


296 


,MDC 


10M 


297 


( MDC 


10M 


C. J O 


Mnr 


1 AM 


299 


,MDC 


10M 


300 


,MDC 


10M 


301 


,MDC 


10M 


302 


,MDC 


IIP 


303 


,MDC 


IIP 


304 


,MDC 


IIP 


305 


,MDC 


IIP 


306 


,MDC 


IIP 


307 


,MDC 


IIP 


308 


,MDC 


IIP 


309 


,MDC 


IIP 


310 


,MDC 


IIP 


311 


,MDC 


IIP 


312 


,MDC 


IIP 


313 


,MDC 


IIP 



SKIN GRAFTS FOR SKIN ULCER OR CELLULITIS AGE >=70 AND/OR C.C 
SKIN GRAFTS FOR SKIN ULCER OR CELLULITIS AGE <70 W/O C.C. 
SKIN GRAFTS EXCEPT FOR SKIN ULCER OR CELLULITIS WITH C.C. 
SKIN GRAFTS EXCEPT FOR SKIN ULCER OR CELLULITIS W/O C.C. 
PERIANAL & PILONIDAL PROCEDURES 

SKIN, SUBCUTANEOUS TISSUE & BREAST PLASTIC PROCEDURES 
OTHER SKIN, SUBCUT TISS & BREAST O.R. PROC AGE >=70 &/OR C.C 
OTHER SKIN, SUBCUT TISS & BREAST O.R. PROC AGE <70 W/O C.C. 
SKIN ULCERS 

MAJOR SKIN DISORDERS AGE >=70 AND/OR C.C. 
MAJOR SKIN DISORDERS AGE <70 W/O C.C. 
MALIGNANT BREAST DISORDERS AGE >=70 AND/OR C.C. 
MALIGNANT BREAST DISORDERS AGE <70 W/O C.C. 
NON-MALIGANT BREAST DISORDERS 
CELLULITIS AGE >=70 AND/OR C.C. 
CELLULITIS AGE 18-69 W/O C.C. 
CELLULITIS AGE 0-17 
TRAUMA TO THE SKIN, SUBCUT TISS & 
TRAUMA TO THE SKIN, SUBCUT TISS & 
TRAUMA TO THE SKIN, SUBCUT TISS & 
MINOR SKIN DISORDERS AGE >=70 AND/OR C.C. 
MINOR SKIN DISORDERS AGE <70 W/O C.C. 



BREAST AGE >=70 &/0R C.C. 
BREAST AGE 18-69 W/O C.C. 
BREAST AGE 0-17 



AMPUTATIONS FOR ENDOCRINE .NUTRITIONAL & METABOLIC DISORDERS 
ADRENAL & PITUITARY PROCEDURES 

SKIN GRAFTS & WOUND DEBRIDE FOR ENDOC ,NUTRIT & METAB DISORDERS 
O.R. PROCEDURES FOR OBESITY 
PARATHYROID PROCEDURES 
THYROID PROCEDURES 
THYROGLOSSAL PROCEDURES 
OTHER ENDOCRINE, NUTRIT & METAB O.R. 
OTHER ENDOCRINE, NUTRIT & METAB O.R. 
DIABETES AGE >=36 
DIABETES AGE 0-35 
NUTRITIONAL & MISC. 
NUTRITIONAL & MISC. 
NUTRITIONAL & MISC, 



PROC AGE 
PROC AGE 



>70 &/OR C.C. 
<70 W/O C.C. 



METABOLIC DISORDERS AGE >=70 AND /OR 
METABOLIC DISORDERS AGE 18-69 W/O C. 
METABOLIC DISORDERS AGE 0- 



17 



INBORN ERRORS OF METABOLISM 

ENDOCRINE DISORDERS AGE >=70 AND/OR C.C. 

ENDOCRINE DISORDERS AGE <70 W/O C.C. 

KIDNEY TRANSPLANT 

KIDNEY, URETER & MAJOR BLADDER PROCEDURE FOR NEOPLASM 

KIDNEY, URETER & MAJ BLDR PROC FOR NON-MALIG AGE >=70 &/OR C.C 

KIDNEY, URETER & MAJ BLDR PROC FOR NON-MALIG AGE <70 W/O C.C. 

PROSTATECTOMY AGE >=70 AND/OR C.C. 

PROSTATECTOMY AGE <70 W/O C.C. 

MINOR BLADDER PROCEDURES AGE >=70 AND/OR C.C. 

MINOR BLADDER PROCEDURES AGE <70 W/O C.C. 

TRANSURETHRAL PROCEDURES AGE >=70 AND/OR C.C. 

TRANSURETHRAL PROCEDURES AGE <70 W/O C.C. 

URETHRAL PROCEDURES, AGE >=70 AND/OR C.C. 

URETHRAL PROCEDURES, AGE 18-69 W/O C.C. 



REVISED ICD-9-CM DIAGNOSIS RELATED GROUPS 



314 


,MDC 


IIP 


315 


( MDC 


IIP 


316 


,MDC 


11M 


317 


,MDC 


11M 


318 


,MDC 


11M 


319 


,MDC 


11M 


320 


,MDC 


11M 


321 


,MDC 


11M 


322 


,MDC 


11M 


323 


,MDC 


11M 


324 


,MDC 


11M 


325 


,MDC 


11M 


326 


,MDC 


11M 


327 


,MDC 


11M 


328 


,MDC 


11M 


329 


,MDC 


11M 


330 


,MDC 


11M 


331 


,MDC 


11M 


332 


,MDC 


11M 


333 


,MDC 


11M 


334 


,MDC 


12P 


335 


,MDC 


12P 


336 


,MDC 


12P 


337 


,MDC 


12P 


338 


,MDC 


12P 


339 


,MDC 


12P 


340 


,MDC 


12P 


341 


,MDC 


12P 


342 


,MDC 


12P 


343 


,MDC 


12P 


344 


,MDC 


12P 


345 


,MDC 


12P 


346 


,MDC 


12M 


347 


( MDC 


12M 


348 


,MDC 


12M 


349 


,MDC 


12M 


350 


,MDC 


12M 


351 


,MDC 


12M 


352 


,MDC 


12M 


353 


,MDC 


13P 


354 


,MDC 


13P 


355 


,MDC 


13P 


356 


,MDC 


13P 


357 


,MDC 


13P 


358 


,MDC 


13P 


359 


,MDC 


13P 


360 


,MDC 


13P 


361 


,MDC 


13P 


362 


,MDC 


13P 


363 


,MDC 


13P 


364 


,MDC 


13P 


365 


,MDC 


13P 



SYMPTOMS AGE >=70 AND/OR C.C 
SYMPTOMS AGE 18-69 W/O C.C. 
SYMPTOMS AGE 0-17 



URETHRAL PROCEDURES, AGE 0-17 
OTHER KIDNEY & URINARY TRACT O.R. PROCEDURES 
RENAL FAILURE W/O DIALYSIS 
RENAL FAILURE WITH DIALYSIS 

KIDNEY & URINARY TRACT NEOPLASMS AGE >=70 AND/OR C.C. 
KIDNEY & URINARY TRACT NEOPLASMS AGE <70 W/O C.C. 
KIDNEY & URINARY TRACT INFECTIONS AGE >=70 AND/OR C.C 
KIDNEY & URINARY TRACT INFECTIONS AGE 18-69 W/O C.C. 
KIDNEY 6c URINARY TRACT INFECTIONS AGE 0-17 
URINARY STONES AGE >=70 AND/OR C.C. 
URINARY STONES AGE <70 W/O C.C. 
KIDNEY & URINARY TRACT SIGNS & 
KIDNEY 6c URINARY TRACT SIGNS & 
KIDNEY & URINARY TRACT SIGNS & 
URETHRAL STRICTURE AGE >=70 AND/OR C.C. 
URETHRAL STRICTURE AGE 18-69 W/O C.C. 
URETHRAL STRICTURE AGE 0-17 

OTHER KIDNEY 6= URINARY TRACT DIAGNOSES AGE >=70 AND/OR C.C. 
OTHER KIDNEY 6c URINARY TRACT DIAGNOSES AGE 18-69 W/O C.C. 
OTHER KIDNEY 6c URINARY TRACT DIAGNOSES AGE 0-17 

MAJOR MALE PELVIC PROCEDURES WITH C.C. 

MAJOR MALE PELVIC PROCEDURES W/O C.C. 

TRANSURETHRAL PROSTATECTOMY AGE >=70 AND/OR C.C. 

TRANSURETHRAL PROSTATECTOMY AGE <70 W/O C.C. 

TESTES PROCEDURES, FOR MALIGNANCY 

TESTES PROCEDURES, NON-MALIGNANT AGE >=18 

TESTES PROCEDURES, NON-MALIGNANT AGE 0-17 

PENIS PROCEDURES 

CIRCUMCISION AGE >=18 

CIRCUMCISION AGE 0-17 

OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY 
OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC EXCEPT FOR MALIG 
MALIGNANCY, MALE REPRODUCTIVE SYSTEM, AGE >=70 AND/OR C.C. 
MALIGNANCY, MALE REPRODUCTIVE SYSTEM, AGE <70 W/O C.C. 
BENIGN PROSTATIC HYPERTROPHY AGE >=70 AND/OR C.C. 
BENIGN PROSTATIC HYPERTROPHY AGE <70 W/O C.C. 
INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM 
STERILIZATION, MALE 

OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES 

PELVIC EVISCERATION, RADICAL HYSTERECTOMY & VULVECTOMY 
NON-RADICAL HYSTERECTOMY AGE >=70 AND/OR C.C. 
NON-RADICAL HYSTERECTOMY AGE <70 W/O C.C. 
FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES 
UTERUS 6c ADENEXA PROCEDURES, FOR MALIGNANCY 

UTERUS & ADENEXA PROC FOR NON -MALIGNANCY EXCEPT TUBAL INTERRUPT 
TUBAL INTERRUPTION FOR NON -MALIGNANCY 
VAGINA, CERVIX & VULVA PROCEDURES 

LAPAROSCOPY & ENDOSCOPY (FEMALE) EXCEPT TUBAL INTERRUPTION 

LAPAROSCOPIC TUBAL INTERRUPTION 

D&C , CONIZATION & RADIO- IMPLANT, FOR MALIGNANCY 

D&C .CONIZATION EXCEPT FOR MALIGNANCY 

OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES 



142 



REVISED ICD-9-CM DIAGNOSIS RELATED GROUPS 



366, 


MDC 


13M, 


367 


MDC 


13M, 


368, 


MDC 


13M, 


369, 


MDC 


13M, 


370, 


MDC 


14P, 


371, 


MDC 


14P, 


372 


MDC 


14M, 


373 


MDC 


14M, 


374 


MDC 


14P, 


375 


MDC 


14P, 


376 


MDC 


14M, 


377 


MDC 


14P, 


378 


MDC 


14P, 


379, 


MDC 


14M, 


380, 


MDC 


14M, 


381 , 


MDC 


14P, 


382, 


MDC 


14M, 


383, 


MDC 


14M, 


384 


MDC 


14M, 


385 


MDC 


15 , 


386 


MDC 


15 , 


387 


MDC 


15 , 


388 


MDC 


15 , 


389 


MDC 


15 , 


390 


MDC 


15 , 


391 


MDC 


15 , 


392 


MDC 


16P, 


393 


MDC 


16P, 


394 


MDC 


16P, 


395 


MDC 


16M, 


396 


,MDC 


16M , 


397 


,MDC 


16M, 


398 


,MDC 


16M, 


399 


,MDC 


16M, 


400 


,MDC 


17P, 


401 


,MDC 


17P, 


402 


,MDC 


17P, 


403 


,MDC 


17M, 


404 


,MDC 


17M, 


405 


,MDC 


17M, 


406 


,MDC 


17P, 


407 


,MDC 


17P, 


408 


,MDC 


17P, 


409 


,MDC 


17M, 


410 


,MDC 


17M, 


411 


,MDC 


17M, 


412 


,MDC 


17M, 


413 


,MDC 


17M, 


414 


,MDC 


17M, 



MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM AGE >=70 AND/OR C.C. 
MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM AGE <70 W/O C.C. 
INFECTIONS, FEMALE REPRODUCTIVE SYSTEM 
MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS 

CESAREAN SECTION WITH C.C. 
CESAREAN SECTION W/O C.C. 

VAGINAL DELIVERY WITH COMPLICATING DIAGNOSES 
VAGINAL DELIVERY W/O COMPLICATING DIAGNOSES 
VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C 
VAGINAL DELIVERY WITH O.R. PROC EXCEPT STERIL AND/OR D&C 
POSTPARTUM DIAGNOSES W/O O.R. PROCEDURE 
POSTPARTUM DIAGNOSES WITH O.R. PROCEDURE 
ECTOPIC PREGNANCY 
THREATENED ABORTION 
ABORTION W/O D&C 
ABORTION WITH D&C 
FALSE LABOR 

OTHER ANTEPARTUM DIAGNOSES WITH MEDICAL COMPLICATIONS 
OTHER ANTEPARTUM DIAGNOSES W/O MEDICAL COMPLICATIONS 

NEONATES, DIED OR TRANSFERRED 
EXTREME IMMATURITY, NEONATE 
PREMATURITY WITH MAJOR PROBLEMS 
PREMATURITY W/O MAJOR PROBLEMS 
FULL TERM NEONATE WITH MAJOR PROBLEMS 
NEONATES WITH OTHER SIGNIFICANT PROBLEMS 
NORMAL NEWBORNS 

SPLENECTOMY AGE >=18 
SPLENECTOMY AGE 0-17 

OTHER O.R. PROCEDURES OF THE BLOOD & BLOOD FORMING ORGANS 
RED BLOOD CELL DISORDERS AGE >=18 
RED BLOOD CELL DISORDERS AGE 0-17 
COAGULATION DISORDERS 

RETICULOENDOTHELIAL & IMMUNITY DISORDERS AGE >=70 AND/OR C.C. 
RETICULOENDOTHELIAL & IMMUNITY DISORDERS AGE <70 W/O C.C. 

LYMPHOMA OR LEUKEMIA WITH MAJOR O.R. PROCEDURE 
LYMPHOMA OR LEUKEMIA WITH MINOR O.R. PROC AGE >=70 AND/OR C.C. 
LYMPHOMA OR LEUKEMIA WITH MINOR O.R. PROCEDURE AGE <70 W/O C.C. 
LYMPHOMA OR LEUKEMIA AGE >=70 AND/OR C.C. 
LYMPHOMA OR LEUKEMIA AGE 18-69 W/O C.C. 
LYMPHOMA OR LEUKEMIA AGE 0-17 

MYELOPROLIF DISORD OR POORLY DIFF NEOPLASM W MAJ O.R. PROC & C.C 
MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R. PROC W/O C.C. 
MYELOPROLIF DISORD OR POORLY DIFF NEOPL WITH MINOR O.R. PROC 
RADIOTHERAPY 
CHEMOTHERAPY 

HISTORY OF MALIGNANCY W/O ENDOSCOPY 
HISTORY OF MALIGNANCY WITH ENDOSCOPY 

OTHR MYELOPROLIF DISORD OR POORLY DIFF NEOPL DX AGE>=70 &/OR C.( 
OTHR MYELOPROLIF DISORD OR POORLY DIFF NEOPL DX AGE<70 W/O C.C. 



REVISED ICD-9-CM DIAGNOSIS RELATED GROUPS 



415 


,MDC 


18P 


416 


,MDC 


18M 


417 


,MDC 


18M 


418 


,MDC 


18M 


419 


,MDC 


18M 


420 


,MDC 


18M 




MDC 


1 8M 


422 


,MDC 


18M 


423 


,MDC 


18M 


424 


,MDC 


19P 


425 


,MDC 


19M 


426 


,MDC 


19M 


427 


,MDC 


19M 


428 


,MDC 


19M 


429 


,MDC 


19M 




Mnr 




431 


,MDC 


19M 


432 


,MDC 


19M 


433 


,MDC 


20 


434 


,MDC 


20 


435 


,MDC 


20 




MDC 




437 


,MDC 


20 


438 


,MDC 


20 


439 


,MDC 


2 IP 


440 


,MDC 


2 IP 


441 


,MDC 


21P 


442 


,MDC 


21P 


443 


,MDC 


2 IP 


444 


,MDC 


21M 


445 


,MDC 


21M 


446 


,MDC 


21M 


447 


,MDC 


21M 


448 


,MDC 


21M 


449 


,MDC 


21M 


450 


,MDC 


21M 


451 


,MDC 


21M 


452 


,MDC 


21M 


Hj J 


Mnr 


9 1 M 
in 


454 


,MDC 


21M 


455 


,MDC 


21M 


456 


,MDC 


22 


457 


,MDC 


22 


458 


,MDC 


22P 


459 


,MDC 


22P 


460 


,MDC 


22M 



461 
462 
463 



MDC 23P 
MDC 23M 
MDC 23M 



O.R. PROCEDURE FOR INFECTIOUS & PARASITIC DISEASES 
SEPTECEMIA AGE >=18 
SEPTECEMIA AGE 0-17 

POSTOPERATIVE & POST -TRAUMATIC INFECTIONS 
FEVER OF UNKNOWN ORIGIN AGE >=70 AND/OR C.C. 
FEVER OF UNKNOWN ORIGIN AGE 18-69 W/0 C.C. 
VIRAL ILLNESS AGE >=18 

VIRAL ILLNESS & FEVER OF UNKNOWN ORIGIN AGE 0-17 
OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES 

O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS 

ACUTE ADJUST REACT & DISTURBANCES OF PSYCHOSOCIAL DYSFUNCTION 

DEPRESSIVE NEUROSES 

NEUROSES EXCEPT DEPRESSIVE 

DISORDERS OF PERSONALITY & IMPULSE CONTROL 

ORGANIC DISTURBANCES & MENTAL RETARDATION 

PSYCHOSES 

CHILDHOOD MENTAL DISORDERS 

OTHER DIAGNOSES OF MENTAL DISORDERS 

SUBSTANCE USE & SUBST INDUCED ORGANIC MENTAL DISORDERS, LEFT AMA 

DRUG DEPENDENCE 

DRUG USE EXCEPT DEPENDENCE 

ALCOHOL DEPENDENCE 

ALCOHOL USE EXCEPT DEPENDENCE 

ALCOHOL & SUBSTANCE INDUCED ORGANIC MENTAL SYNDROME 

SKIN GRAFTS FOR INJURIES 

WOUND DEBRIDEMENTS FOR INJURIES 

HAND PROCEDURES FOR INJURIES 

OTHER O.R. PROCEDURES FOR INJURIES AGE >=70 AND/OR C.C. 

OTHER O.R. PROCEDURES FOR INJURIES AGE <70 W/O C.C. 

MULTIPLE TRAUMA AGE >=70 AND/OR C.C. 

MULTIPLE TRAUMA AGE 18-69 W/O C.C. 

MULTIPLE TRAUMA AGE 0-17 

ALLERGIC REACTIONS AGE >=18 

ALLERGIC REACTIONS AGE 0-17 

TOXIC EFFECTS OF DRUGS AGE >=70 AND/OR C.C. 

TOXIC EFFECTS OF DRUGS AGE 18-69 W/O C.C. 

TOXIC EFFECTS OF DRUGS AGE 0-17 

COMPLICATIONS OF TREATMENT AGE >=70 AND/OR C.C. 

COMPLICATIONS OF TREATMENT AGE <70 W/O C.C. 

OTHER INJURIES, POISONINGS & TOXIC EFF DIAG AGE >=70 AND/OR C.C. 
OTHER INJURIES, POISONINGS & TOXIC EFF DIAG AGE <70 W/O C.C. 

BURNS, TRANSFERRED TO ANOTHER ACUTE CARE FACILITY 
EXTENSIVE BURNS 

NON-EXTENSIVE BURNS WITH SKIN GRAFTS 

NON-EXTENSIVE BURNS WITH WOUND DEBRIDEMENT & OTHER O.R. PROC 
NON-EXTENSIVE BURNS W/O O.R. PROCEDURE 

O.R. PROC WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES 

REHABILITATION 

SIGNS & SYMPTOMS WITH C.C. 



144 



REVISED ICD-9-CM DIAGNOSIS RELATED GROUPS 

464, MDC 23M, SIGNS & SYMPTOMS W/O C.C. 

465, MDC 23M, AFTERCARE WITH HISTORY OF MALIGNANCY AS SECONDARY DX 

466, MDC 23M, AFTERCARE W/O HISTORY OF MALIGNANCY AS SECONDARY DX 

467, MDC 23M, OTHER FACTORS INFLUENCING HEALTH STATUS 

468, ** UNRELATED OR PROC 

469, ** PDX INVALID AS DISCHARGE DIAGNOSIS 

470, ** UNGROUPABLE 



»*- 15 *o 



re Lj 

01 O 



c 

V> k- » 

oi re <nj 

l~ 01 o 
O. Q. 

L. reel 

O w X 



C\J 
VI 

01 t- T3 

u re c 

C 01 S3 

oi a. 

t/l o. • 

jd re 
re 



! S~ 

: o 



°8 
Oi £ 
u 

c c 

Ol — 



o — - 

01 



the Dresenci 
)om procedun 
>e exception 1 


aqe 70 or 0' 
or compllca 
le exception' 
and 23) 


the presenci 
or compllca 
05, 09, 12, 

the presenci 
i one hour (i 


division on 
operating r< 
MDCs with tl 


division on 
comorbidity 
MOCs with tl 
19, 20, 22, 


division on 
comorbidity 
01, 02, 04, 

division on 
areater thai 



VI o 
X3 O 

re X 



— 

01 v> 



o> oi 

VI c 
Ol c 



c o> 

O T> 

f- re 

i/i o 

> re 

"O v> 



o 



c 

Ol V) 



CL — - o. *i 



Ol o 

Ol c 

VI 

-O 

re vj 

u re 

O Ol 



a. •— 



t- re 

vi 

t- T3 



Ol Q. 

u re 
c — - 

Ol 

Vi c 

oi o 
t- ■•- 



VI (- 

— o 
> f-1 
~- re 
■o E 



— u re 



ice of 
toe 


•*- **- 

o 

01 Ol 


•nee or abser 
>er Umb and 


;nce or abser 
irs In mpc 0' 

;nce or abser 


n on the prest 
1on of the udi 

s in MDC 05) 


n on the presi 
or only (apDe; 

n on the prest 


divlslo 
amputat 
(aopear 


divlslo 
nenerat 

divlslo 



re • — 



Ol 

c 
o 



>> 

c 

o 



«■> c 
re re 

4-1 

3 £> 



(.1 o 

!- 

1 en 



oi re 

£8 



o •— 



o 

I 



C Cr 

c c 

s re 

o u 



Ol o 

■z S, 

U VI 
V) 

Oi vi 

■O 3 

o 

O T- 

*J t_ 

K 

0> > 

£: o, 




Ol c 
re o 

f- u 



46 



2 
I 



<•- 


• «5 

v- it- 


• 

w «— . 


absence ( 
osis 


absence ( 
(appears 

absence ( 
(appears 


absence < 

In MDC 0", 


■esence or 
:u1ar dlaqn 


■esence or 
rollcatlon 

■al hernia 


•esence or 
? (appears 


Ion on the pi 
!x card1ovas< 
irs In MDC 0! 


Ion on the pt 
wascular cor 

: 05) 

Ion on the pi 
lal and fetnoi 

: 06) 


Ion on the pi 
OP proceduri 


— Q. D. 
TJ O — 


dlvlsl 
card1( 

i n ni/i 

dlvls* 
In HOI 


d1v1s< 
major 



So 



VI C 
OI • — 
t- IO 
Q. C O 
O 

£Zo 

« 

c u c 

o ■>-> — 

g 2 v. 



* — 

VI 

« c 

ID 

n 

c w 

£ o* 



vi * — 
— - n 

> 4-* 
— O 



•I « 

C O- 

oi o. 

vi io 



Ot- 

« I. 
Oi c = 

UUP 

c oi S 

VI c 

A — l- 
m o 

it- 
k. o o. 

— 
i — £ 

y > o> 
C O -c 

01 E *» 

VI w 



— - > 
e vi oi c 
o — -o t- 



•n •— *> Oi 
- • « a 

i«i s- 



oo 

si 

Ol 

VI C 

x> — 

VI 

• 

• s 

u o 
c • 

Ol' — ■ 
VI 

01 > 
C I 



VI O 
^- 4-1 

> A 

*- 3 

vi 



Ol 



2 



© 

i. 
o 



« o »- 




147 



S8 



t. 10 U i« 

o«— o £- 

■0 

O O DO. 
C — CO. 
QJ (/) 01 « 



t 5 



o 

T3 JD 



1/1 > — 

in 
> .o 



CI u8 



oi *-» c 
0) x 



i *j ai £* 5 

a. -c a; c 

1 e *•£ §■ 

i 01 O 01 



> o- o 
•o > a. 



a « 

o> c 

«/» 

« « 

> 

I. «T 

g»— 

01 1- <-> 
U 4-» O 

E .-a E 
01 u 
t/l *•- c 

Ol ^" H- 

>- S- 

°-g £ 

01 U 10 



c C >> era 

o n> t- o — 

mT) > t/i o 

> >.>— >«o 

«- C 01 1- 

T> 10 T3 "DO 



01 c£ 



Ol *> 
U « 

c c 

oi o 



*J 

01 o 



01 TJ 

in 0) 
Ol 4-1 — 



oj u o 
£ O 



51 



c 

01 "~ 

u c 

£ & 

a. n 



e 



o z 



> —t 
=5 1 



*£ -5. 



II 



4/» 



m e 

iS 



EO) 
m 

o 

a «-> 

{ « V) 

z u oi 

in 

e c <?> 

C oi io 
o — — 
Z U-) o 



1- 01 
o u 

II 




148 



o 

c c 



> — oi 

I e Q. 

i a. o. 

. IQ 



: -o u 

« C 

i u a> 

■ f- O- 



ai — 
u a> 



i- § us 

end 
a 

o> — <_> 
a> — 

VI c c 
L. ~- 

au i» 
c u 

01 •»- *o 



o a. 

01 vi 
ai jc L 



o,.?2! 
u f— u 
c m c 
u E <c 
vi o 
a* to 
i- — -o 



<*- E <•> . 



v> c 

XI IB • — 

<o c ©■> 
oi© 
t. — 
O — <_) 



C 10 t 

out 

i- — u 
^1 — cx •— »— 

i- C 10 »■ ~ 



*-» O. Q. ra oj 

Q. 4-> 
C *D T C ^ VI 

O or — ■ o >, 
I — I/) 



c « 

o a. 

US 

in u no 
i- c — 
>-»-*— o 

i- I. i- D 
■O O.J2 X 



i- i- o 
VI u o 

-- c x 
> 1- 



l/l 

£ 

am n 
o o> 

01 C Q. 

x: o> o 

4-> « 10 
C T> 

o *■> 

> — i/i 

C 10 <o 

O CL OJ 
in U£ 

*- c 

> — 01 
i- h. JC 



U VI 

i- o 
•— c 



re 

U iA 
~ g 



-— (J 

<o c 
a. re 
— ■ c 

c — 



a. a 
— c 
u ai 
c i- 



«j o i- 

u 

e >, vi 
0i o L 
m c io 
J3 a 0> 
■oca. 
oi a. 

k — IO 

— — 
« 

01 E vi 
u — 

C *J 

oi o — 

VI 

OI VI 3 

a. vi — 

o 01 
01 c u 
j= o- 
v n l 
— o 
c -o 

O t- 
«- OI 
c 10 u 
o a.— 

VI o 

•■- e c 
> •»- 1- 
— i. 
•o awi 



o — 

VI 3 

VI — 
O OI 



»- at 

10 <J 

a.— 



ai o & 

U 10 

c 

01 u 

iflCk 
£ « 01 
10 C V 

oi-o 
L. i- a 

— — 
a xi 

fl) E . 

C O 

01 O i-i 
VI ID 

01 vi E 

Q. 1/1 TD 



i- 01 
c *o ■*-» 
O 0J . — 

C « 3f- 
O Cv 

vi u oTc) 
i- c c X 
> i- -o 
i- t — c 

■O O..K i- 



O a 



Oi o 

VI 

OI VI 

O. VI 

o 

01 c 

X Cr 

«-> ID 



c «- 

o a. 

i- i- o 

vi u o 



IO VI 

o.— 

— VI 
i- IO 

a. o 



u 



I 




150 



o 

<*- 
01 o 

u 

e >, 

s £ 

x> re 
« c 

cr. 

u ■•- 

— . — 

CM 

« 6 — 

ssg 

vi X 

01 vi 

4. f- c 
aw 
o 

0* c v> 
£ cnl. 
«■> a « 
«- ai 
c -o o. 
o a. 



> — in 

•r U 41 



VI 

«- L. 

01 O ID 
U 01 

c >, a. 

oi u a. 

t» c a 

^ <o — 

• c _ 

i— *> 

-is. 

U VI 
c <<- 

01 o Oi 
v> > 
01 in t- 

£> 4J 
CL 1/1 l_> 
O 3 
01 CXI 
£ C O 
+J ID C 
•>- CL 
OI 

o 

CM 

c Id OI — 

«u in 
t- c z: 
> — 01 
••- s- x: c 

•O Cl*» — 



e — 

5° c 

C >■> « 

S u o> 

m c a. 

xi « a. 

<o c <o 

«..?~ 

° 5 I 
Oi Ef 

g ov £ 

01 D in 

1/1 

CP in Oi 

o. VI i- 
o *-> 
0> C <J 
C OI3 
4/ « ^ 
i- o 
c -o C 

O CL 

«— OI 
C <0 I_ 
O CL — 

f oi rn 
vt u f— »— VI 

">—§<_> "> 
^ u So — 



■ <_> x- i 

> e o ! 



J3 £ 



O 4J 
0. 
C Id 

o a. 



U f 

c 

OI VI 



OI 



> 

01 



01 O 

u 

SI 



— — 

01 <t- <-> 

0) CO 
OI Id Id 

x — a> 



In — E 



— 

01 VI 



«©. is a 

U 5,1-- L- 



CL o 

l/l 

0) VI 
L. t- 

CL V) 

o 
OI c 
f C7I 
4-> 10 



c n 

o cl— 
— i-OO 

VI U — 

ii^ 

■O CLX 



O 3 



01 > 

VI — 
X> VI 
*3 VI 



01 T3 

U 

C «- 
01 O 

v> 

cu i/> - — - 
u — en 
a. vi — 
o 

oi c u 
x cr>o 
w Hi 



gs VI 
a. 0> 

— — <o 

HI U (J 

> — CL 

— 0- ■ 

■o Co.— 



— 

01 $ 



OI 4-> 

1/1 VI 

X) c 



i- cr. 

•»■ — 

o 

01 4-1 PJ 



ai l. 
<- o c 
o. — 



4J B <0 

4-> OI 
C VI CL 



— U — 
> VI > 

— t- -o 
•o-o « 



II 



ex 

CL 
< 



a 

>> 
— u 
<o c 

CL 10 

i- c 
u cn 
c 1- 

II 



en 
io 

5 

>> 

f— u 
Id c 
CL Id 





islon 


of 


Id 

CL 

u 
c 


Is Adml; 


agnosis 
Leukeml i 


>artum P 
iosIs 


rered th 


:1pa1 D1 
loma or 


Post| 
Oiagr 


Delli 


Prim 
Lympt 



VI 
V) 

o c 

£v> 8 

Id c 

5|§ 

*— LU 
CL O 



VI VI 
— OI 
VI VI 



o 

OI 

— > 



— CL 

otoS 




419-177 - 84 — 1 1 



151 



O G CM 
ID 

0) CJ 

o o o 



lie, 



5 

I 



° E 



0J t/> - 

i- •»- o 



CL trt CM 
O 

II cu 
.c cx>o 



C D. —CO. 



U Q Q 
C L. 10 
01 4-> — 



01 3 



l o ir> 
a. .— 

V) 

f o 



*J 0) ai c 

WD in O 
L. I> 3 f- 
01 O *-> 

a. ai o.--~ 
O •— u O) ro 

SLUM 
•d- U 3 K 
O " O 4IT3 
.C i/l C 

ai oi ib 

■M O 
C CM 



a. t. 



■ m vi • 

J3UOJ 
I D — 



i/> ai ■ 
— u 



i- t- o c in 



I— U 

<e c 
o. ai 

— TJ 

u c 

C Oi 
f- o. 

U 01 

a. o 



■o — 
OI *~ 



•4-> O 



5 e 




152 



sajnpaDOJd yo 




O 
c 
bo 
< .2 
r- Q 

5.2. 

£5 



T3 
C 

0) 



C 

c 

o 



op 
13 



O 

U 



o 

T3 



T3 

.5 

o 
E 

3 

il 

u 
u 



153 




E 

<U 

■i— i 

1/1 

IS) 
Ul 
3 
O 

c: 

. . <u 

r- Z 

<=> <U 

O ^ "o 

SP ° = 



"O 



^ o 



Q § 



r <u _ 



03 

cu 



r 5 q 5 



a 



G. 



U0ip9JU| 



sjapjosia 

3AJ9Ni 



|pj3qdua<j 
pue |eiuFJ3 








o 


"o 


so 
c 








5 




u 

u 


orde 


T3 

a. 




U-j 








ul 


b 






O 




■a 




c 


TJ 


Me 




ao 


C 






ns 




tN 


5 


un 
0) 


-5; 






i/i 








03 






CD 


2? 


OS 




LO 






2 


b 






2 



jp|nDoej;u| J3L|;o 



jp|nooej;x3 jaq;o 



su| AjEujud 



wo 



a 

a 



sasougpiQ jaq;o 



sjapjosin 



|eoi§0|Ojnafvj 



*3 " 



< 




a 1 
a. ..>• 



o -J 
a i 



a -i 



in 

T 

Q 
cx 

a 



51 

a ; 



a 



*3 

a 



T 

O 

sr 

a 




a 
a 



u 




T 

O 



T 

Q 

a 



o 



o 
-a 



■g 
15 
5 

5 

ii 

u 
u 



156 



AoiojOoUuAw 



piouapv f/- & 
pup|(suox 



piouapv pue 



|ISU01 




2f 

T3 

«*■ 
u 

a 

ac v.; 



o 



njr, 

u 



' 2 



o 



-a 
c 

S- 

o 



O <u 



< 

m 



in 
O 

c 

0X3 



-a 



-a 
c 



A;s^|douiqy 



jeg pue 



snoaueiposiw 



piojsew 



pue snuis 



jieday ajeiPd 



pue dn yao 



pueiQ 



AjeAi|es 



aj a. 



g 



a s 




t 

3 £ 

TO Of 




a 

>p3N pue peaH at 
joleyv 



m 

a 
a 



QC 

a 



z5 a 5 



157 





m 
o 

o 

U 
o 

1/1 
O 

c 

£B .2 
rn Q 
<u w 

i .a 

00 fH 



(T3 

o 



XI 

c 

0/ 



LU 



-a 



Q 
-a 

1) 





si;iwo|gidg «. 



sixp;sidg * 



an 



Q 



| 

Lunuqi|inb3sXa q_ j 



. a -I 



Z 5 Q § 



c 
E 
c 
U 

5 

T3 



o 
p 

o 
u 



158 




159 



E 

1/1 
>> 

o 



o 

U 

u O 

— i/i 



1/1 

o 
c 

S3 

^ a 
5.2. 



T3 



c 

03 



Sun - ) |Ei}|}SJ3ju| 



Xsunaid pue 



.3 
Q 

£ y 



3Aipnj;sqo siuojiq 



Ajojejidsay pue 
ewapg ^euoujinj 



eiunejj_ 
jolew 



LUSE|d03N 



suoi}bujlue^u| 



pue suoipsjui 



ujsi|oqujg 
Ajeuoaiin,-) 





as 

a 



a 
a 



3 

& 

ac 

a, 



as 

a 
a 




o 

a. 



r-. 
O 



Q 5 



o 

T3 



■g 
Ig 
o 
P 
a 
U 



U 

u 



160 




161 





O 



Q 

a 



— "3 ~ 

a. — nj 

E ~ 

5^ % 

Z. -a <u 

o £ I 

"° a if 

" s ~ 

3 -s c 
-9 3° 

= i| I! 

Six 
u - 



LiPI(3Sul?Jl U^-l-l ac 
Q 



162 




163 



aft, <> 



a, 
er 



in 
o 

2* 
o 

<u 
(d 
U 
u 

1/1 
o 
c 

O .2 
m Q 



E 

4* 
i/» 

o 

3 
U 
w 

4> 



o 

w 

<U 

■o 
o 

1/1 



-a 
c 

f8 
i/l 
4) 
t/t 
f« 
0) 
i/l 



sasouSeiQ Jamo 



9sde||03 pue adoDuAs 



PUjSuv 



sjapjosiQ uoipnpuo^; 

pue PIUJLI^MJ-IV 



ie|nA|E/\ pue |P}iu33ucq 



uoisuaysdAn 



SIS0j3pS0J3U,}V 



jein^sEA |ej3udu3<j t« 




Q 



a 

Q 



5ijiq3|gdoqujojLjj_ 



UI3A d33Q 



>pou,s pue 3jn|ie-j pesn 
sijipjBDopug 



3}n:>eqns pue 3}rov 



a 



o 
a 



OC. 

ex 

(N 

a 



Q. 

5 
u 

5 
-a 



o 

5 
u 

ii 

u 
u 



164 




165 



O . \ 




419-177 - 



84 - 



12 



167 




168 



Fv «-» 

M 5 

acta 

< i 




o 
a 



o 
a 



smsoinH 



jaq;o 



3 



a. 
ac 
Q 




Off 

< 




'• a 

due luaaiapuqsa at 

- Gfe 

puno/v\ 



Asdoig 



a 



>p3N PUE >peg 



1^ ~ 

Al O 

** — 

< S 





o 

a: 
Q 



U 

a 



_0J 



00 ^ 
O 

^£ 

8 £ $ 
13 jjj |= 
u IE 



U O 



3 Q 
c "a 

130 c 

<<TJ "3 

00 Q oj _ 

« «- £ c 

2- Q 03 5 
3 .X, 0> 



no 
c 

'c 
g 

r 

Q- 



80 

5 

V") 



uoi;E}nduuv 



diH J3U.JO 



a 

or 
a 



1 




JUjOf JOlEVV 



a 

ac 

a 




c 
o 
U 

o 
-a 
c 



-g 

o 
I 
o 

U 

il 

u 
u 



169 



CO 

o 

o 
aa 
<u 
*■> 
<« 



o 
c 

co .2 
a» >- 



CD 

"2 P 

O OJ 

.12 > 

Q '-6 

T3 CD 

c c 

03 C 

lo O 

CD (J 

CD C 

b 



saoiAaa uoijExi-j 



o U 

■< c 

(3 



on 

a 




pue uoisoxg |e:>cn 



-a. 
X 



puEH 



U 

o M 

— Ai ° 

snssii ^os « 73 

< 5 



IT! 



jaddn-ismo 



O 
at 



o u 

FN. w 
AI O 

CO § 

< i 



Q 
a: 
Q 



a 






Of 

Q 



O 
O 



OK 

rx 
rv 

s 

a 
*> 

a 



rx 

CM 

a 
oc 
a 

nt 
<N 

O 
cc 

a 




a 

Q 



a 



o 
-a 
c 



■g 

-Q 

5 

5 
u 

ii 

u 
u 



170 



A~3UEUgl|EW Pug r* 





00 




o 








o 




QJ3 




<X» 




■*-> 
n» 




<J 








</» 




O 




C 




euo 


o 




00 Q 


<u 


w 


w 




3 




Of 




U- 


5 



E 

-l-l 
+-> 

u 
3 

I) 



O 0J 

.!£ > 

-a qj 
c c 

H3 C 

i/i o 
cu U 
1/1 -r-i 

0j C 

Q 



i 

a 

5 •? 



S|1!|3XUJ031SO 



'diH p uo|jeDO|Sia 



d|H 10 sjnpejj 



jnuuaj jo ainppj-j 



an 

a, 



»•*> 
Q 

a 



U 
cc 

a 



in 
<■»> 

a 
a 



c 

'£ 
o 

a. 



00 

© 

o 

<u 

(fl 
<J 

o 
'■13 

l/l 

o 
c 

Q -2 
co Q 

= * 
op ™ 

iZ 2 



1) 



3 



C 0) 

i£ > 

Q tS 

« I 
^ -n 



;asou§sia JsqiO 

§31 J3M0"| 

pup uuv jaddn 

(0 UOI}P30|SIQ J 




pup uiejjs 



}OOJ pup 
PUPH LUIP3JOJ 
p UOI}P0O|Sia 

pup uipjis 



uipjds 'sjnppjj'* 



" ; O 
3JP0J3}4V " C£ 

pup saisoXw '" ^ 




"sijiuopusi v- 2^". ; 



SLUOldUiAs^'f ^ 



pupsuSis. § 



AMiedojq^v 

7 cr % 

- 



Aqjpdojqpv 
Dijpsds pup 




•<** 

— — — — — a 

>ppg |PDipaw g 



7 O 



a u 

^ nS5 'l At 5 

< « 




a 
<r 
Q 

Or 

T 

rN 

GC 

a 



O 

u 



o 
-a 



■c 
.a 

o 
P 
5 
u 

il 

u 
u 



172 




ON <U q5 

O c 

OX) O <T3 

U en qj 



o 
c 

< .2 

5-2. 
iz5 



O r- 

Q S 

c c 

03 05 



© 
ao 
<u 



6 , _ 



e 




c 

'c 
o 

r 

a. 



a. 
E 
o 

u 

o 
■o 



-5 
o 
£ 

o 

u 

II 

u 
u 



o 
z 



o 
z 



$ 

o 

a: 
Q 

a\ 
m 

O 
or 

a 

• SR 
o 
a 

in 
o» 
O 
a: 

a 



173 




174 



sajnpaDOJd 






176 




177 




179 





uoi;pzi|U3}s 




uoi}Piuwe|ju| 



Aqdoj}J3dAH 
oi}p;sojd uSiuag 



O o 

QO J, 

"£ ^ 

™ "n 

U 5 

U o 

._ 1£ 

"5? Q 

o _ 



-c E 



00 00 

P4 .2 



~ o ra 

iZ 5 Q 



<U 
> 

u 
O 

a. 

a: 




00 

c 
c 
o 



5 f 



Q. 

E 

o 
u 

o 

T3 



■g 

!5 
a 
E 
o 

u 


u 



180 




182 




419-177 O - 84 -- 13 



l 




o 
so 
<u 

<« 

u 

u 

35 
1/1 

o 
c 

vo.2 
r- Q 

= •§• 



C 

DO 



c 

's 

o 



■a 
o 

JO 
CD 

TD 
C 

<TJ 

-a 
o 
o 

CD £ 

£ "S 

M_ O 

O .!£ 

52 Q 
ai 

* u 



o 

b 

c 

i/i F 
cu _ 

"3 -a 



on 
O 

o 
c 

£ 




■c 

a. 

u 
T3 
i> 

2 



ao 
5 



IBiiamopusoinDrjay , 

















uoi;B|n3B03 




SJ3pJOS!Q 



1133 pooia pay 




184 




o 
-a 
c 

ra 

T3 

1 
O 

E 



185 





186 




m 

if ' i 
Jmm 



3 



<L> 

"O 



T3 
C 



ON 
O 

a» 
« 
u 

u 
'•S 
t/» 
O 
c 

o\ ■- 
«- Q — 

1.2. c 

iz5 5 



c 

'c 
o 



a 

CI .> 



sasoipAsd, 



uoiiBpjeiay |B}uaw puff 



lOJ^uo^ as|nduj| puir 



a i 



m 

•r 

O 

a 



a ' 

at 



/^!|PUOSJ3d JO SJ3P-IOSIQ 



o 
a 




rr 

O 

a 

O 
at 

a 



uoipun^s/a |eDOSOipAs<± 
p saDueqjnjsiQ pue 



O 

a 



<T3 

SD 

b 



"a 
5 



T3 

o 



Cl 

E 
o 

p 



a. 

o 



187 




188 



Appendix III: MEDPAR 
version of diagnosis-related groups 



MEDPAR refers to Medicare Provider Analysis 
and Review, which is a 20 percent annual sample of 
Medicare hospital discharges. The data set does not 
contain all the information required to form DRGs, 
and some patient groups had to be modified to 
accommodate this restricted set of data elements. The 
limitations of the data set and the corresponding 
modifications are discussed in the context of the 
variables required to form DRGs. 

Secondary diagnoses 

Specific secondary diagnoses are not included in 
the MEDPAR data set. However, the presence or 
absence of additional diagnoses beyond the principal 
is indicated. As a result, the following two 
modifications to the DRGs were made for the 
MEDPAR version: 

• DRGs defined on the basis of a substantial 
comorbidity or complication are defined on the 
basis of the presence of any secondary diagnosis. 

• DRGs defined on the basis of specific secondary 
diagnoses are not formed. For example, DRGs 387 
and 388 corresponding to premature newborns with 
and without major problems are not defined as such 
in the MEDPAR version. Instead, there is a single 
prematurity group for newborns with or without 
major problems. 

Operating room procedures 

Only one surgical code is listed, with an indication 
of the presence or absence of additional procedures. 
Thus, DRGs defined on the basis of specific 
secondary procedures are not formed in the 
MEDPAR version. For example, DRGs 106 and 107, 
corresponding to coronary bypass with and without 
catheterization, are not defined as such in the 
MEDPAR version. Instead, there is a single group 



(labelled DRG 107) containing coronary bypass 
patients with or without catheterization. Moreover, 
because only one procedure is given, there is no 
"looping" or scanning of procedures. As a 
consequence, a discharge is assigned to a DRG based 
on the first listed procedure rather than on the most 
resource intensive procedure, as determined by 
scanning all procedures, the patient underwent during 
his hospital stay. 

Discharge status 

Information pertaining to discharge status is limited 
to "dead" or "alive." Modifiications were made to 
MDCs 15 (DRGs 385 to 391) and MDC 20 (DRGs 
433 to 438). DRGs 385 through 391, originally 
defined in terms of newborns "transferred or died," 
are defined in the MEDPAR version on the basis of 
death alone. DRG 433, originally defined as patients 
in MDC 20 who left against medical advice, is 
eliminated in the MEDPAR version. Moreover, 
whether or not a patient left against medical advice is 
not a criterion for membership in the other 
MEDPAR DRG*s in MDC 20 (DRGs 434 through 
438). 

Tree diagrams 

The remainder of this section provides descriptive 
information concerning the structure and content of 
the MEDPAR ICD-9-CM Diagnosis-Related 
Groups. This material includes: 

• Abbreviated definitions of the MEDPAR DRGs. 

• Key to the symbols used in the tree diagrams. 

• Tree diagrams of the MEDPAR DRGs 
superimposed on the diagnosis for the original 
ICD-9-CM DRGs to facilitate comparisons 
between the two versions. 



194 



MEDPAR Listing of Twenty-Three Major Diagnostic Categories 

and 

Listing of DRGs with Abbreviated MEDPAR English Descriptions 



Major Diagnostic Major Diagnostic Category 
Category Number English Description 



01 Diseases and Disorders of the Nervous System 

02 Diseases and Disorders of the Eye 

03 Diseases and Disorders of the Ear, Nose 

and Throat 

04 Diseases and Disorders of the Respiratory System 

05 Diseases and Disorders of the Circulatory System 

06 Diseases and Disorders of the Digestive System 

07 Diseases and Disorders of the Hepatobiliary 

System and Pancreas 

08 Diseases and Disorders of the Musculoskeletal 

System and Connective Tissue 

09 Diseases and Disorders of Skin, Subcutaneous 

Tissue and Breast 

10 Endocrine, Nutritional, and Metabolic Diseases 

and Disorders 

11 Diseases and Disorders of the Kidney and Urinary 

Tract 

12 Diseases and Disorders of the Male Reproductive 

System 

13 Diseases and Disorders of the Female Reproductive 

System 

14 Pregnancy, Childbirth and the Puerperium 

15 Newborns and Other Neonates with Conditions 

Originating in the Perinatal Period 

16 Diseases and Disorders of the Blood and Blood- 

Forming Organs and Immunological Disorders 

17 Myeloproliferative Diseases and Disorders and 

Poorly Differentiated Neoplasms 

18 Infectious and Parasitic Diseases [Systemic or 

Unspecified Sites] 

19 Mental Diseases and Disorders 

20 Substance Use and Substance Induced Organic 

Mental Disorders 

21 Injuries, Poisonings and Toxic Effects of Drugs 

22 Burns 

23 Factors Influencing Health Status and Contacts 

with Health Services 



195 



MDC 01P 
MUC OIP 
MDC OIP 
MDC OIP 
MDC OIP 
MDC OIP 
MDC OIP 
MDC OIP 
MDC OlM 
MDC OlM 
MDC OlM 
MDC OlM 
MDC OlM 
MDC OlM 
MDC OlM 
MDC OlM 
MDC OlM 
MDC OlM 
MDC OlM 
MDC OlM 
MDC OlM 
MDC OlM 
MDC OlM 
MDC OlM 
MDC OlM 
MDC OlM 
MDC OlM 
MDC OlM 
MDC OlM 
MDC OlM 
MDC OlM 
MDC OlM 
MDC OlM 
MDC OlM 
MDC OlM 
MDC 02P 
MDC 02P 
MDC 02P 
MDC 02P 
MDC 02P 
MDC 02P 
MDC 02P 
MDC 02M 
MDC 02M 
MDC 02M 
MDC 02M 
MDC 02M 
MDC 02M 
MDC 03P 
MDC 03P 
MDC 03P 
MDC 03P 
MDC 03P 
MDC 03P 
MDC 03P 
MDC 03P 
MDC 03P 
MDC 03P 
MDC 03P 
MDC 03P 
MDC 03P 



MEDPAR Listing of Twenty-Three Major Diagnostic Categories 

and \ 

Listing of DRGs with Abbreviated MEDPAR English Descriptions 

CRANIOTOMY AGE >=18 EXCEPT FOR TRAUMA 
CRAMOTCMY FOR TRAUMA AGE > = 18 
CRANIOTOMY AGE <18 
?pina£ PROCEDURE 



XTRACRAMAL VASCULAR PROCEDURES 
CARPAL TUNNEL RELEASE 

❖PER1PH £ CRANIAL NERVE £ OTHER NERV SYST PROC AG 
*PERIPH £ CRAM 1 AL NERVE £ OTHER NERV SYST PROC AG 
SPINAL DISORDERS £ INJURIES 
*NERVOUS SYSTEM NEOPLASMS AGE >=70 AND/OR DX2 . 
*NLRVOUS SYSTEM NEOPLASMS AGE <70 W/0 DX2 . 
DEGENERATIVE NERVOUS SYSTEM DISORDERS 
MULTIPLE SCLEROSIS £ CEREBELLAR ATAXIA 
SPECIFIC CEREBROVASCULAR DISORDERS EXCEPT T I A 
TRANSIENT ISCHEMIC ATTACKS 

❖NONSPECIFIC CEREBROVASCULAR DISORDERS hi TH DX2. 

❖NCNSPEC IFIC CEREBROVASCULAR DISORDERS W/C DX2 . 

*CRAMAL £ PERIPHERAL NERVE DISLRDERS AGE > = 70 AND/CR DX2 . 

❖CRANIAL £ PERIPHERAL NERVE DISORDERS AGE <70 W/0 DX2 • 

NERVOUS SYSTEM INFECTION EXCEPT VIRAL MENINGITIS 

VIRAL MENINGITIS 

HYPERTENSIVE ENCEPHALOPATHY 

NONTRAUMATIC STUPOR £ COMA 

❖ SEIZURE £ HEADACHE AGE > = 70 AND/OR DX 2 . 

❖SEIZURE £ HEADACHE AGE 18-69 W/C DX2. 

SEIZURE i HEADACHE AGE 0-17 

TRAUMATIC STUPOR £ COMA, COMA >1 HR 

❖TRAUMATIC STUPOR £ COMA, COMA <1 HR AGE >=70 AND/CR DX2. 
❖TRAUMATIC STUPOR £ COMA <1 HR AGE 18-69 W/0 DX2. 
TRAUMATIC STUPOR £ CUMA <1 HR AGE 0"17 
❖CONCUSSION AGE >=70 AND/OR DX2 • 
❖CONCUSSION AGE 18-69 W/0 DX2. 
CONCUSSION AGE 0-17 

❖OTHER DISORDERS OF NERVOUS SYSTEM AGE >=70 AND/CR 0X2 . 
*OTHER DISORDERS OF NERVOUS SYSTEM AGE <7C W/0 DX2. 
RETINAL PROCEDURES 
0RE1TAL PROCEDURES 
PRIMARY IRIS PROCEDURES 
LENS PROCEDURES 

EXTRAOCULAR PROCEDURES EXCEPT ORBIT AGE >=18 
EXTRAOCULAR PROCEDURES EXCEPT ORBIT AGE 0"17 
INTRAOCULAR PROCEDURES EXCEPT RETINA, IRIS £ LENS 
HYPHEMA 

ACUTE MAJOR EYE INFECTIONS 
NEUROLOGICAL EYE CISORLERS 

❖OTHER DISORDERS OF THE EYE AGE >=18 WITH CX2 • 
*0 THER DISORDERS OF ThE EYE AGE >=18 W/C 0X2. 
OTHER DISORDERS OF THE EYE AGE 0-17 
MA^OR HEAD £ NECK PROCEDURES 
❖SIALOADENECTOMY 

❖SALIVARY GLAND PROCEDURES EXCEPT SIALOADENECTOMY 

CLErT LIF £ PALATE REPAIR 

SINUS £ MASTOID PROCEDURES AGE >=18 

SINUS £ MASTOID PROCEDURES AGE 0-17 

MISCELLANEOUS EAR, NOSE £ THROAT PROCEDURES 

RHINOPLASTY 

T£ A PROC EXCEPT TONSILLECTOMY £/CR ADENUI DECTOMY AGE >=18 
T£A PROC EXCEPT TONSILLECTOMY £/0R ApENCI DECTOMY AGE 0-17 
TONSILLECTOMY AND/OR ADENOIDE CTOMY AGE >= 18 
TONSILLECTOMY AND/OR ADEN01DECTOMY AGE C-17 
MYRINGOTOMY AGE >=18 



>=70 £/0R DX2. 
<70 W/0 UX2 • 



♦Represent changes to the new ICD-9-CM DRGs necessitated because of data 
limitations of MEDPAR. 



196 



,MDC 
tMDC 
,MDC 
»MDC 
,MDC 
,MDC 
,MDC 
,MDC 
,MDC 
,MDC 
,MDC 
iMOC 
,MDC 
• HOC 
,MDC 
,MDC 
i HOC 
,MDC 
,MDC 
,MDC 
,MDC 
,MDC 
iMDC 
,MDC 
,MDC 
,MDC 
,MDC 
,MDC 
,MDC 
,MDC 
,MDC 
,MDC 
,MDC 
,MDC 
,MDC 
,MDC 
,MDC 
,MDC 
,MDC 
,MDC 
,MDC 
,MDC 
,MDC 
,MDC 
,MDC 
,MDC 
,MDC 
,MDC 
,MDC 
,MDC 
,MDC 
tMDC 
,HDC 
,MDC 
.MDC 
tMDC 
,MDC 
tMDC 
,MDC 
,MDC 
,MDC 



03P 
03P 
03M 
03M 
03M 
03M 
03M 
03M 

03 M 
03M 
3M 
03M 
03M 
OHP 

04 P 
04P 
04M 
04 M 
04M 
0<»M 
C4M 
04M 
04M 
04M 
04M 
04M 
04M 
04M 
04M 
04M 
G4M 
04M 
04M 
04M 
04M 
04M 
04M 
0<+M 
04M 
04M 
04M 
05P 
05P 
05P 
05P 
05P 
05P 
QbP 
05P 
05P 
05P 
05P 
ObP 
05P 
ObP 
ObP 
QbP 
05P 
ObP 
ObM 
5M 



UR1 AGE >=70 AND/OR 0X2. 
URI AGE 18-69 W/0 DX2. 



MEDPAR Listing of Twenty-Three Major Diagnostic Categories 

and v \ 

Listing of DRGs with Abbreviated MEDPAR English Descriptions 
MYRINGOTOMY AGE 0-17 

OTHER EAR, NUSE C THRCAT O.R. PROCEDURES 
EAR, NOSE £ THROAT MALIGNANCY 
CYSEGU1L1BRIUM 
EPISTAX1 S 
EPIGLOTTITIS 
*0 T 17 1 S MEDIA £ 
»>0T I T IS MEDIA £ 
OTITIS MEDIA £ OR I AGE 0-17 
LAR YNGQTRACHE I TI S 
NASAL TRAUMA G DEFCR M I TY 

OTHER EAR, NOSE L THRCAT DIAGNOSES AGE >= 16 
OTHER EAR, NOSE £ THROAT OIAGNOSES AGE C-17 
MAJCP CHEST PROCEDURES 

*0.R. PRCC ON THE RESP SYSTEM EXCEPT MAJOR CHEST WITH 0X2 . 
♦O.R. PROC ON THE RESP SYSTEM EXCEPT MAvOR CHEST W/L 0X2. 
PULMONARY EMbOL I SM 

*RE SPIRATORY INFECTIONS £ INFLAMMATIONS AGE > = 70 AND/OR DX2 • 
♦RESPIRATORY INFECTIONS £ INFLAMMATIONS AGE 18-69 W/0 0X2. 
RLSPIRATCRY INFECTIONS £ INFLAMMATIONS AGE 0-17 
RESPIRATLRY NEOPLASMS 

*MAJCR CHEST TRAUMA AGE >=70 AND/OR 0X2. 



*MAJCk ChESJ TRAUMA AGE <70 W/0 DX2 . 
♦PLELRAL Ef FUSION AGE >=70 AND/OR 0X2 • 
*PL EURAL EFFUSION AGE <70 W/0 DX2. 
PULMCNAR Y EDEMA £ RESPIRATORY FAILURE 
CHRONIC CESTRUCT1VE PULMONARY DISEASE 

♦ SIMPLE PNEUMONIA £ PLEURISY AGE >= 70 AND /OR DX2. 

♦ SIMPLE PNEUMONIA £ PLEURISY AGE 18-69 */C DX2 • 
SIMPLE PNEUMONIA G PLEURISY AGE C-17 

♦ I N TERST IT I AL LUNG DISEASE AGE > = 70 AND/OR DX2 . 
♦INTERSTITIAL LUNG DISEASE AGE <70 W/U CX2. 
♦PNEUMOTHORAX AGE >=70 AND/OR DX2. 

*PNE UMOT HQRAX AGE <70 W/U DX2. 
♦BRONCHITIS £ ASTHMA AGE > = 70 AND/OR DX2. 
♦BRONCHITIS g ASTHMA AGE 18-69 W/0 DX2. 
BkCNCHlTIS £ ASTHMA AGE 0-17 

♦R E SP IR ATORY SIGNS £ SYMPTOMS AGE > = 70 AND/OR DX2 . 
♦RESPIRATORY SIGNS £ SYMPTOMS AGE <70 w/0 0X2. 
♦OTHER RESPIRATORY OIAGNOSES AGE >=70 AND /CR DX2. 
♦OTHER RESPIRATORY DIAGNOSES AGE <70 W/C DX2 
HE/>RT TRANSPLANT 

♦ NLT IN USE FOR ME CP AR DATA SET 
♦CARDIAC VALVE PROCEDURE WITH PUMP 

♦ NET IN USE FOR MEUPAR DATA SET 

♦ CCRCNAR Y BYPASS 

CARCIOTHCR PROC, EXCEPT VALVE £ CCRONARY BYPASS, WITH PUMP 
CARLI0THCRAC1C PROCEOURES W/0 PUMP 

♦MAJOR RECLNSTRUCT 1VE VASCULAR PROCEDURES AGE >=70 AND /OR 0X2 . 
♦M A JCR RECONSTRUCTIVE VASCULAR PROCEDURES AGE <70 W/U 0X2 • 
VASCULAR PROCEOURES EXCEPT MAJOR RECONSTRUCTION 
*A^PUTATI0N FOR CIRC SYSTEM CISCRDERS E.-.CEFT UPPER L 1Mb C TOE 
♦UPPER LIME £ TOE AMPUTATION FCR CIRC SYSTEM DISORCERS 
PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI OR CHF 
PERMANENT CARDIAC PACEMAKER IMPLANT K/0 AMI OR CHF 
♦CARDIAC PACEMAKER REPLACE £ REVIS EXC PULSE GEN REPL ONLY 
♦CARDIAC PACEMAKER PULSE GENERATOR REPLACEMENT ONLY 
VEIN LIGATION £ STRIPPING 

OTHER O.R. PROCEDURES ON THE CIRCULATORY SYSTEM 

♦ NOT IN USE FUR MEDPAR DATA SET 

♦CIRCULATORY DISORDERS WITH AMI £ DISCH. ALIVE 



197 



123, MDC 

124 , MDC 

125 , MDC 

126 ,MDC 
127 ,MDC 

128 ,MDC 

129 ,MDC 
130, MDC 

131 ,MDC 

132 ,MDC 
133 ,MDC 

134 ,MDC 

135 ,MDC 

136 , MDC 

137 ,MDC 

138 ,MDC 
139, MDC 
140 ,MDC 
141 , MDC 

142 ,MDC 

143 ,MDC 

144 ,MDC 

145 , MDC 

146 ,MDC 

147 ,MDC 
148, MDC 
149 ,MDC 
150, MDC 

151 ,MDC 

152 ,MDC 
153, MDC 

154 ,MDC 

155 ,MDC 

156 ,MDC 

157 ,MDC 

158 ,MDC 

159 ,MDC 

160 ,MDC 

161 ,MDC 

162 ,MDC 

163 ,MDC 

164 ,MDC 

165 ,MDC 

166 ,MDC 

167 ,MDC 
163 , MDC 
169 ,MDC 

170 , MDC 

171 , MDC 
172 ,MDC 
173 ,MDC 

174 ,MDC 

175 ,MDC 

176 , MDC 

177 , MDC 

178 ,MDC 

179 ,MDC 

180 ,MDC 

181 ,MDC 

182 , MDC 

183 , MDC 



05M 
05M 
05M 
05M 
05M 
05M 
05M 
05M 
05M 
05M 
05M 
05M 
05M 
05M 
05M 
05M 
05M 
05M 
05M 
05M 
05M 
05M 
5M 
06P 
06P 
06P 
06P 
06P 
06P 
06P 
06P 
06P 
06P 
06P 
06P 
06P 
06P 
C6P 
06P 
06P 
06P 
06P 
06P 
06P 
06P 
06P 
06P 
06P 
06P 
06M 
06M 
06M 
06M 
06M 
6M 
06M 
06M 
06M 
06M 
06M 
06M 



MEDPAR Listing of Twenty-Three Major Diagnostic Categories 

and \ j ' 

Listing of DRGs with Abbreviated MEDPAR English Descriptions 
CI RCULATCRY DISORDERS WITH AMI, EXPIRED 

❖CIRCULATORY DISCRDERS EXC AMI , WITH CARD CATH £ COMP DX1 
❖CIRCULATORY DISCRDERS EXC AMI, WITH CARD CATH £W/C COMP DX1 
ACLTE £ SUBACUTE ENDOCARDITIS 
HEART FAILURE L SHOCK 
DEEP VEIN THROMBOPHLEBITIS 
CARDIAC ARREST 

❖PERIPHERAL VASCULAR DISORDERS AGE > = 70 AND/OR DX2. 
❖PERIPHERAL VASCULAR DISORDERS AGE < 70 W/0 DX2 • 
ATHEROSCLEROSIS AGE >=70 AND/OR DX2 • 
ATHEROSCLEROSIS AGE <70 W/0 DX2 • 
HYPERTENSION 

❖CARCIAC CCNGEMTAL £ VALVULAR DISORDERS AGE > = 70 AND/OR DX2. 
❖CARCIAC CONGENITAL £ VALVULAR DISORDERS AGE 18-69 W/L DX2 • 
CARDIAC CONGENITAL £ VALVULAR DISORDERS AGE 0"17 
❖CARDIAC ARRHYTHMIA £ CONDUCTION DISORDERS AGE >=7C AND/OR DX2. 
❖CARCIAC ARRHYTHMIA £ CONDUCTION DISORDERS AGE <70 W/0 DX2 • 
ANGINA PECTORIS 

❖SYNCOPE £ COLLAPSE AGE >=70 AND/OR DX2. 
❖SYNCOPE £ COLLAPSE AGE <70 W/C DX2 . 
CHEST PAIN 

❖OTHER CIRCULATORY DIAGNOSES WITH DX2. 
*OTHER CIRCULATORY DIAGNOSES W/0 DX2. 
❖RECTAL RESECTION AGE >=70 AND/CR 0X2 . 
❖RECTAL RESECTION AGE <70 W/0 DX2 . 

❖MAJOR SMALL £ LARGE BOWEL PROCEDURES AGE >=70 AND/OR DX2. 
❖MAJOR SMALL & LARGE BOWEL PROCEDURES AGE <70 W/0 CX2 • 
❖PERITONEAL ADHESIOLYSIS AGE >=70 AND/OR 0X2. 
❖PERITONEAL ADHESIOLYSIS AGE <70 W/0 0X2* 

❖MINOR SMALL £ LARGE BOWEL PROCEDURES AGE >=70 AND/OR DX2 • 
❖MINOR SMALL £ LARGE BOWEL PROCEDURES AGE <70 W/U LX2. 

£ DUODENAL PROCEDURES AGE >=70 AND/OR DX2 . 
C DUODENAL PROCEDURES AGE 18-69 W/0 DX2 • 
-■o.urMin. cJumMucML & DUODENAL PROCEDURES AGE 0*17 
❖ANAL PROCEDURES AGE >=70 AND/OR DX2. 
❖ANAL PROCEDURES AGE <70 W/C DX2. 

❖HERNIA PRCCEDURES EXCEPT INGUINAL £ FEMORAL AGE > = 70 AND/OR DX 2 • 
❖HERNIA PRCCEDURES EXCEPT INGUINAL £ FEMORAL AGE 18-69 W/U DX2. 
❖ INGUINAL £ FEMORAL HERNIA PROCEDURES AGE > = 70 AND/LR DX2 • 



❖STOMACH, ESOPHAGEAL 
❖STOMACH, ESOPHAGEAL 
❖STOMACHj ESOPHAGEAL 



❖ INGUINAL f. FEMORAL HERNIA FROCEDURES AGE 18*69 W/C DX2. 
HERNIA PROCEDURES AGE C'17 

❖APPENDECTOMY WITH COMPLICATED PRINC. DIAG AGE>=70 AND/OR DX2. 



DIAG AGE <70 W/0 DX2. 
D I AG AGE >=7C AND/OR DX2. 
DIAG AGE <70 W/0 DX2. 



❖A FPENDE CTOMY WITH COMPLICATED PRINC 
❖APPENDECTCMY W/0 COMPLICATED PRINC, 
❖A FPENDE CT CM Y W/0 COMPLICATED PRINC. 
❖PROCEDURES ON THE MOUTH AGE >=70 AND/OR DX2. 
❖PROCEDURES ON THE MOUTH AGE <70 W/0 DX2. 
MOTHER DIGESTIVE SYSTEM PRCCEDURES AGE >= 70 AND/OR DX2. 

❖ OTHER DIGESTIVE SYSTEM PROCEDURES AGE <7 W/0 DX2 . 
❖DIGESTIVE MALIGNANCY AGE > = 70 AND/OR 0X2 • 
❖DIGESTIVE MALIGNANCY AGE <70 W/0 DX2. 

❖G.l. HEMORRHAGE AGE >=70 AND/OR DX2. 

❖ G.I. HEMORRHAGE AGE <70 W/C DX2 . 
COMPLICATED PEFTIC ULCER 

❖UNCOMPLICATED PEPTIC ULCER >=70 AND/OR DX2. 
❖UNCOMPLICATED PEPTIC ULCER <70 W/0 DX2. 
INFLAMMATORY BOWEL DISEASE 
❖G.I. OBSTRUCTION AGE >=70 AND/CR DX2 . 
❖G.I. OBSTRUCTION AGE <70 W/C DX2. 

❖ E SOPHAG I TIS,GASTROENT.£ MISC. DIGEST. CIS AGE >=70 £/0R DX2. 
❖ESOPHAGITIS,GASTRCENT.£ MISC. DIGEST. CIS AGE 18-69 W/0 DX2. 



198 



18* ,MDC 
18b ,MDC 
186 ,MDC 
18 7, MDC 
166 , MDC 

189, MDC 

190, MDC 

191 , MDC 
192 ,MDC 
193, MDC 
19«»,MDC 
19 5 t MDC 

196, MDC 

197, MDC 
196, MDC 
199 , MDC 
20C ,MDC 

201 , MDC 

202, MDC 
203 ,MDC 
20* , MDC 
205, MDC 
206 ,MDC 
20 7, MDC 
20c, MDC 
209 ,MDC 

21 , MDC 
211 , MDC 
212 , MDC 
213, MDC 
21*, MDC 

215, MDC 

216, MDC 

217, MDC 
216 , MDC 

219, MDC 

220, MDC 
221 , MDC 

222, MDC 

223, MDC 
22* ,MDC 

225 , MDC 

226 , MDC 

227 , MDC 
228, MDC 

22 9, MDC 

230 , MDC 

231 , MDC 

232 , MDC 
233, MDC 
23* ,MDC 
235 , MDC 

236, MDC 

237, MDC 

238, MDC 

239, MDC 
2*0, MDC 
2*1, MDC 
2*2, MDC 
2*3 , MDC 
2** ,MDC 



06M 
ObM 
06M 
06M 
06M 
06M 
06 M 
07P 
07P 
07P 
07P 
07P 
07P 
07P 
07P 
07P 
07P 
07P 
07M 
07M 
07M 
07M 
07M 
07M 
7M 
08P 
OSP 
06P 
OfcP 
08 P 
OfcP 
OfcP 
08P 
06P 
C6P 
06P 
OfcP 
OfcP 
OfcP 
08P 
OfcP 
08P 
06F 
OfcP 
OfcP 
08P 
OfcP 
08P 
OfcP 
OfcP 
OfcP 
05M 
OfcM 
CfaM 
OfcM 
OfcM 
OfcM 
OfcM 
OfcM 
OoM 
OfcM 



>=70 AnD/OR DX2. 
16-69 W/0 DX2 . 



MEDPAR Listing of Twenty-Three Major Diagnostic Categories 

and \ j 

Listing of DRGs with Abbreviated MEDPAR English Descriptions 

ESCPHAGITIS, GASTROENTERITIS £ MISC. DIGEST. DISORDERS 
♦DENTAL L CRAL DIS. EXC EXTRACT IONS £ RE STLRAT ION S, AGE 
♦CENTAL £ URAL DIS. EXC EXTRACTIONS £ REST CRATlbNS, AGE 
❖CENTAL EXTRACTIONS £ RESTORATIONS 
❖OTHER DIGESTIVE SYSTEM DIAGNOSES AGE 
❖OTHER DIGESTIVE SYSTEM DIAGNOSES AGE 
OTHER DIGESTIVE SYSTEM DIAGNOSES AGE 0-17 
❖MAJOR PANCREAS, LIVER £ SHUNT PROCEDURES 
♦MINOR PANCREAS, LIVER £ SHUNT PROCEDURES 
❖BILIARY TRACT PROC EXC TOT CHOLECYSTECTOMY 
♦BILIARY TRACT PROC ExC TOT CHOLECYSTECTOMY 
❖NOT IN USE FOR MEDPAR DATA SET 
*NOT IN USE FOR MEDPAR DATA SET 

❖ TOTAL CHOLECYSTECTOMY AGE > = 7C AND/OR DX2 . 
❖TOTAL CHOLECYSTECTOMY AGE <70 to/0 0X2. 
HEPATOBILIARY DIAGNOSTIC PROCEDURE FOR MALIGNANCY 
HEPATOBILIARY DIAGNOSTIC PROCEDURE FOR NON-MALIGNANCY 
OTHER HEPATOBILIARY LR PANCREAS O.R. PROCEDURES 
CIRRHOSIS £ ALCOHOLIC HEPATITIS 

MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS 
DISORDERS CF PANCREAS EXCEPT MALIGNANCY 

❖ DISORDERS OF LIVER EXC MAL I G , C 1RR , ALC HE FA AGE 

❖ DISORDERS OF LIVER EXC MAL 1 G ,C 1RR , ALC HEP A AGE 
❖DISORDERS OF THE BILIARY TRACT AGE >=70 AND/OR 
* DISORDERS OF THE BILIARY TRACT AGE <70 to/0 DX2. 
MAJOR JOINT FROCEDLRES 

❖HIP I FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >=70 AND/OR 



AGE 0-17 



AGE 
AGE 



>=70 £/0R 0X2 . 
<70 W/0 DX2. 



>=70 AND/OR DA 2, 
<70 h/0 CX2. 
DX2 . 



DX2. 



❖HIP £ FEMLR PROCEDURES EXCEPT MAJOR oulNT AGE ld-69 K/0 DX2. 
HIP £ FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE G"17 
AMPUTATIONS FLR MUSCULOSKELETAL SYSTEM £ CONN. TISSUE DISORDERS 
*6 ACK £ NECK PROCEDURES ^ Cc >=7C AND/OR DX 2 . 

❖ BACK £ NECK PROCEDURES AGE <70 to/0 DX2 • 

BIOPSIES OF MUSCULOSKELETAL SYSTEM £ CONNECTIVE TISSUE 

toND DEER I D £ SKN GRFT EXC HAND, FOR MUSCSKELETAL £ C ONN .TlSS.ClS 

♦LOtoER EXTREM £ HUME R PROC EXC HIP ,FCOT , FEMUR AGE > = 70 £/0R CX2. 

❖ LOWER EXTREM L HUMER PROC EXC H IP , FOOT , FEMUR AGE lti-69 to/0 DX2. 
LOtoER EXTREM £ HUMER PROC EXC HIP, FOOT , FEMUR AGE C-17 

❖ KNEE PROCEDURES AGE > = 70 A.WuR 0X2 • 

AGE <70 to/C DX2. 
PROC EXC HUMERUS £ HAND AGE 
PROC EXC HUMERUS £ HAND AGE 



❖KNEE PROCEDURES 
❖UPPER EXTREMITY 
❖UPPER EXTREMITY 
FCGT PROCEDURES 
❖ SOFT TISSUE F ROC E DURE S AGE 
♦SOFT TISSUE PROCEDURES AGE 
GANGLION (HAND) PROCEDURES 
HAND PROCEDURES 
❖LOCAL EXCISION 



>=70 AND/OR DX2 • 
<70 to/C DX2. 



>=70 AND/OR 0X2 • 
<70 to/0 DX2. 



❖LOCAL EXCISION 
ARTHROSCOPY 



EXCEPT GANGLION 
£ REMOVAL LF INT FIX DEVICES 
£ REMOVAL OF I NT FIX DEVICES 



O.R 
O.R 



PROC 
PROC 



AGE 
AGE 



♦OTHER MUSCULOSKELET SYS £ CONN TISS 
❖LTHER MUSCULOSKELET SYS £ CONN TISS 
FRACTURES OF FEMUR 
FRACTURES CF HIP £ PELVIS 
PRAINS, STRAINS, £ DISLOCATIONS OF 
STEOMYEL I T I S 
PATHOLOGICAL FRACTURES £ MUSCULOSKELETAL 
♦CONNECTIVE TISSUE DISORDERS AGE >=70 ANC/CR DX2 . 
♦CONNECTIVE TISSUE DISORDERS AGE <70 to/0 DX2. 
SEPTIC ARTHRITIS 
MEDICAL BACK PROBLEMS 

♦BONE DISEASES £ SEPTIC ARTHROPATHY AGE >=70 AND/CR 



OF HIP £ FEMUR 
EXCEPT hIP £ FEMLR 

>=70 £/0R DX2. 
<70 to/0 DX2 • 



HIP, PELVIS £ THIGH 



£ CONN. TISS. MALIGNANCY 



DX2 . 



419-177 O - 84 -- 14 



199 



MEDPAR Listing of Twenty-Three Major Diagnostic Categories 

and \ \ 

Listing of DRGs with Abbreviated MEDPAR English Descriptions 

245 , MDC 06M,*BCNE DISEASES G SEPTIC ARTHROPATHY AGE < 70 W/0 UX2. 

246 , MDC 08M, NON-SPECIFIC ARTHROPATHIES 

247 , MDC 08M, SIGNS C SYMPTOMS OF MUSCULOSKELETAL SYSTEM G CONN TISSUE 
246 , MDC OBM.TENDGNIT IS, MYCS1TIS G BURSITIS 

249, MDC 06M , AFTERCARE * MUSCULOSKELETAL SYSTEM G CONNECTIVE TISSUE 

250, MDC 0£M,*FX,SPRNS,STRNS G DISL OF FOREARM , HAND .FOOT AGE > = 70 G/OR DX2. 

251, MDC 08M,*FX,SPRNS,STRNS G DISL OF FCRE ARM .HAND , FOOT AGE 18-69 W/0 DX2. 
252 , MDC 06M,FX,SFRNS,STRNS C DISL OF F OREARM »HAND, FOO T AGE 0-17 

253, MDC ObM , *FX » SPRNS » STRNS G DISL OF UPARM , LOWLEG EX FOOT AGE > = 7C C/OR DX2. 
254 , MDC O&M ,*FX,SPRNS. STRNS G DISL OF UPARM, LOWLEG EX FOOT AGE 18-69 W/0 DX2. 
255, MDC 06M,FX ,SPRNS,STRNS G DISL CF UPARM, LOWLEG EX FOOT AGE C-17 

256 , MDC 08M , OT HER DIAGNOSES OF MUSCULOSKELETAL SYSTEM G CONNECTIVE TISSUE 

257 , MCC 09P,*TLTAL MASTECTOMY FOR MALIGNANCY AGE >=70 AND/OR CX2. 

258 , MDC 09P,*TCTAL MASTECTOMY FOR MALIGNANCY AGE <70 W/0 DX2. 

259 , MDC 09P,*SUBT0TAL MASTECTOMY FCR MALIGNANCY AGE > = 70 AND/OR UX2. 

260 , MDC 09P ,*SLBTOTAL MASTECTOMY FOR MALIGNANCY AGE <70 

261, MDC 09P»* BREAST FRCC FOR NON-MALIG EXCEPT BIOPSY G LOC EXC 

262 , MDC 09P,*BFLAST EIOPSY G LOCAL EXCISION FOR NON-MALIGNANCY 

263 , MDC 09P,*SKIN GRAFTS FOR SKIN ULCER OR CELLULITIS AGE >=70 AND/OR 0X2 • 
264, MDC 09P,*SKIN GRAFTS FOR SKIN LLCER OR CELLULITIS AGE <70 W/0 DX2 • 

2 65 , MDC 09P,*SK1N GRAFTS EXCEPT FOR SKIN ULCER Ok CELLULITIS WITH DX 2 • 

266 , MDC 09P,*SK1N GRAFTS EXCEPT FOR SKIN ULCER OR CELLULITIS K/0 DX2. 

267 , MDC 09P, PERIANAL C PILONIDAL PROCEDURES 

268 , MDC 09P,SKIN,SU8CUTANcCUS TISSUE G BREAST PLASTIC PROCEDURES 

269 , MDC 09P, MOTHER SKIN, SUBCUT TISS G BREAST O.R. PROC AGE > = 70 G/OR DX2 • 

270 , MDC G9P, *OTHER SKIN, SUBCUT TISS G BREAST O.R. PROC AGE <7C W/0 DX2» 
271, MDC 09M,SKIN ULCERS 

272 , MDC 09M,*MAJCR SKIN DISORDERS AGE > = 70 AND/OR DX2 . 

273 , MDC 09M , *MAJOR SKIN D I SORDEk S AGE <70 w/C DX2. 

27^, MDC 09M ,*MALIGNANT BREAST DISCRDERS AGE >=70 AND /CR DX2. 

275 , MDC 09M , *MAL I GN ANT BREAST DISCRDERS AGE <70 W/0 DX2. 

276 , MDC 09M,N0N-MALIGANT BREAST DISORDERS 

277 , MDC 09M .^CELLULITIS AGE > = 70 AND/OR CX2. 

278 » MDC 09M .^CELLULITIS AGE 18-69 k/0 DX2. 

279 , MDC 09M, CELLULITIS AGE 0-17 

280 , MDC 09M.*TRAUMA TO THE SKIN, SUBCUT TISS G 

281, MDC 09M , *T R AUMA TO THE SKIN, SUdCUT TISS G 

282, MDC 09M, TRAUMA TC THE SKIN, SUBCUT TISS & BREAST AGE 0*17 
283 , MDC 09M, MINOR SKIN DISORDERS AGE > = 70 AND/OR 0X2 • 
284, MDC 09M, MINOR SKIN DISCRDERS AGE <70 W/Q DX2. 

265 , MDC 10P , AMPUTATI CNS FOR ENDUCRINE .NLTRITIONAL & METABOLIC DISORDERS 

266 , MDC 10P, ADRENAL G PITUITARY PROCEDURES 
287 , MDC 10P.SK1N GRAFTS G WOUND DE&R1DE FOR ENDOC » NLTR IT 

268 , MDC 10P,0.R. PROCEDURES FOR UdESITY 

269 , MDC 10P ,PARATHYRCIC PRCCEDURES 

290, MDC 1 OP , THYROID PRCCEDURES 

291, MDC 1 OP, THYRC GLOSSAL PROCEDURES 

292 , MDC lOP.vOTHER ENDOCRINE, NUTRIT G 

293 , MDC 10P , '-'OTHER ENDOCRINE, NUTRIT G 
294, MDC 10M, DIABETES AGE >=36 
295 , MDC 10M, DIABETES AGE 0-35 

296, MDC 10M,*NUTRIT1CNAL G MISC. METABOLIC DISORDERS AGE >=70 AND/UR DX2 • 

297 , MDC 1CM,*NUTR1TI0NAL G MISC. METABOLIC DISORDERS AGE 16-69 W/0 DX2. 

298 , MDC 10M .NUTRITIONAL G MISC. METABOLIC DISORDERS AGE 0*17 

299 , MDC 1 OM » INBORN ERRCRS OF METABOLISM 

300 , MDC 1CM,*ENC0CR1NE DI SGRDERS AGE > = 70 AND/OR DX2 . 
301, MDC 10M »*ENDCCR INE DISORDERS AGE <7C W/0 DX 2 . 

302 , MDC 11P.KICNEY TRANSPLANT 

303 , MDC IIP. KICNEY, URETER G MAJOR BLADDER PROCEDURE FOR NEOPLASM 

304 , MDC IIP,* KICNEY ,LRETER G MA J BLDR PRLC FOR NON-MALIG AGE > = 70 G/CR DX2 . 

305 , MDC IIP,* KIDNEY, URETER G MA J BLDR PROC FCR NON-MALIG AGE <70 W/0 DX2. 



BREAST AGE >=70 G/OR DX2. 
BREAST AGE 18*69 W/0 DX2 . 



G METAB DISORDERS 



METAB O.R. PROC AGE 
METAB O.R. PROC AGE 



>7C G/OK DX2. 
<7C W/0 DX2. 



200 



306 


f MLC 


hp 


307 


»MDC 


l IP 


308 


,MDC 


l ip 


309 


, MDC 


l ip 


310 


t MDC 


l ip 


311 


.MDC 


l ip 


312 


kj P. f 

► MDC 


IIP 


313 


»MDC 


HS 


3H 


.MDC 


up 


315 


,MDC 


hp 


316 


.MDC 


1 1M 


317 


»MDC 


1 1M 


316 


► MLC 


1 1M 


319 


»MDC 


1 1M 


320 


► MDC 


1 1M 


321 


r MDC 


1 1M 


322 


► MDC 


l lM 


323 


► MDC 


l lM 


324 


»MDC 


l lM 


325 


► MDC 


1 1 M 


326 


► MDC 


1 1M 


327 


>MDC 


1 1M 


326 


► MDC 


1 1 M 


329 


► MDC 


11M 


330 


► MDC 


1 lM 


331 


► MDC 


11M 


332 


► MDC 


1 1M 


333 


, MDC 


11M 


334 


► MDC 


12P 


335 


► MDC 


1 2P 


336 


► MDC 


1 2P 


337 


► MDC 


12P 


33 8 


u n r 

► MDC 


1 2P 


339 


► MDC 


12P 


340 


► MDC 


12P 


34 1 


► MDC 


1 2P 


34 2 


► MDC 


1 2P 


34 3 


► MDC 


12P 


344 


► MDC 


1 2P 


345 


► MDC 


\ Z P 


346 


► MDC 


1 2M 


347 


► MDC 


12M 


346 


► MDC 


12M 


3 4 9 


► MDC 


12M 


350 


► MDC 


1 2M 


35 1 


► MDC 


12M 


352 


► MDC 


12M 


353 


► MDC 


1 3P 


354 


► MDC 


1 3P 


355 


»MDC 


13P 


356 


► MDC 


1 3P 


357 


► MDC 


1 3P 


358 


► MDC 


1 3P 


259 


► MDC 


13P 


DO U 


la r-. c 
i MUU 


1 3P 


361 


iMOC 


13P 


362 


.MDC 


13P 


36 3 


,MDC 


13P 


364 


,MDC 


13P 


365 


.MDC 


13P 


366 


,MDC 


13M 



>=70 AND/OR QX2. 
16-69 W/D 0X2. 



MEDPAR Listing of Twenty-Three Major Diagnostic Categories 

and \ A - 

Listing of DRGs with Abbreviated MEDPAR English Descriptions 

*PRCSTATECTOMY AGE >=70 AND/CR DX2 . 
❖PROSTATECTOMY AGE <70 W/0 DX2 • 

❖MINOR 6LACDER PROCEDURES AGE > = 70 AND/GR CX2 • 
*MINCR BLADDER PRCCEDLRES AGE <70 W/0 DX2 . 
❖TRANSURETHRAL PROCEDURES AGE >=70 AND/OR 0X2 • 
* TRANSURETHRAL PROCEDURES AGE <70 W/0 DX2 . 
❖URETHRAL PROCEDURES » AGE > = 70 AND/OR 0X2 • 

❖ URETHRAL PROCEDURES . AGE 16-69 W/0 0X2. 
URETHRAL PROCEDURES* AGE 0-17 

OTHER KIDNEY £ URINARY TRACT O.R. PROCEDURES 
RENAL FAILLRE W/0 DIALYSIS 
RENAL FAILLRE WITH DIALYSIS 

*K 1 CNEY I URINARY TRACT NECFLASMS AGE >=70 AND/OR 0X2. 
❖KIDNEY £ URINARY TRACT NEOPLASMS AGE <70 W/0 DX2 . 
*K1CNEY E URINARY TRACT INFECTIONS AGE >=7C AND/OR LX2 • 

❖ KIDNEY E URINARY TRACT INFECTIONS AGE 16-69 W/0 DX2 * 
KIDNEY £ URINARY TRACT INFECTIONS AGE 0-17 
❖URINARY STONES AGE >=70 AND/OR 0X2. 
❖URINARY STONES AGE <70 W/0 0X2. 
*K I DNE Y £ URINARY TRACT SIGNS £ SYMPTOMS Ai 
❖KIDNEY C URINARY TRACT SIGNS £ SYMPTOMS A> 
KIDNEY I URINARY TRACT SIGNS £ SYMPTOMS AGE 0-17 

❖ URETHRAL STRICTURE AGE >=70 AND/OR 0X2 . 
❖URETHRAL STRICTURE AGE 18-69 W/0 0X2. 
URETHRAL STRICTURE AGE 0~17 

❖OTHER KIDNEY £ URINARY TRACT DIAGNOSES AGE > = 70 AND/OR 0X2 • 

❖OTHER KIDNEY f URINARY TRACT DIAGNOSES AGE 18-69 W/Q 0X2 • 

OTHER KIDNEY £ URINARY TRACT DIAGNOSES AGE 0-17 

❖MAJOR MALE PELVIC PROCEDURES WITH 0X2. 

❖MAjCR MALE PELVIC PROCEDURES W/0 0X2. 

❖TRANSURETHRAL PRCST A TtCTOM Y AGE >=70 AND /OR 0X2 . 

❖TRANSURETHRAL PROSTATECTOMY AGE <70 W/C 0X2. 

TESTES PROCEDURES • FOR MALIGNANCY 

TESTES PROCEDURES, NON-MALIGNANT AGE > = 18 

TESTES PROCEDURES * NON-MAL 1 &NANT AGE 0-17 

PENIS PROCEDURES 

CIRCUMCISION AGE >=16 

CIRCUMCISION AGE 0-17 

OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY 
OTHER MALE REPRODUCTIVE SYSTEM C.R. PROC EXCEPT FOR MALlG 
❖MALIGNANCY, MALE REPRODUCTIVE SYSTEM,* AGE >=70 ANL/UR 0X2 • 
❖MALIGNANCY, MALE REPRODUCTIVE SYSTEM,* AGE <70 W/C DX2. 
❖BENIGN PRCSTATIC HYPERTROPHY AGE > = 70 AND/OR 0X2 * 
❖BENIGN FRCSTATIC HYPERTROPHY AGE <70 W/0 0X2 . 
INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM 
STERILIZATION, MALE 

OTHER MALE REPRODUCTIVE SYSTEM OIAGNUSES 

PELVIC EVISCERATION, RADICAL HYSTERECTOMY £ VULVECTLMY 

❖NGN-RADICAL HYSTERECTOMY AGE >=70 ANO/OR 0X2. 

❖NON-RADICAL HYSTERECTOMY AGE <70 W/0 DX2 . 

FEMALE REPRODUCTIVE SYSTEM RECCNSTRUCT I VE FROCEDURES 

UTERUS E ADENEXA PROCEDURES, FCR MALIGNANCY 

❖UTERUS £ ADENEXA PRUC FOR NON-MALIGNANCY EXCEPT TUEAL INTERRUPT 
❖TUBAL INTERRUPTION FCR NON-MALIGNANCY 
VAGINA, CERVIX £ VULVA PROCEDURES 

❖LAPAROSCOPY £ ENDQSCCPY (FEMALE) EXCEPT TUBAL INTERRUPTION 

❖LAPAROSCOPIC TUbAL I N TERR UPT I CN 

D£C, CONIZATION £ R AD I 0- 1 MP L AN T , FOR MALIGNANCY 

D£C ,CONI ZAT10N EXCEPT FOR MALIGNANCY 

OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES 

❖MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM AGE >=70 AND/OR 0X2. 



201 



367 

363 

369 

370 

371 

372 

373 

374 

375 

376 

377 

376 

379 

360 

3bl 

382 

383 

36 4 

365 

366 

387 

366 

369 

390 

391 

392 

393 

394 

395 

395 

397 

398 

399 

400 

401 

402 

403 

404 

405 

406 

4 07 

408 

409 

410 

411 

412 

413 

414 

415 

4 16 

417 

416 

419 

420 

421 

422 

423 

424 

4 25 

426 

427 



MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 
MDC 



13M 
13M 
13M 
14P 
14P 
14M 
14M 
14P 
14P 
14M 
14P 
14M 
14M 
14M 
14M 
14M 
14M 
14M 
15 
15 
15 
15 
15 
15 
15 
16P 
16P 
16P 
16M 
16M 
16M 
1 6M 
16M 
17P 
17P 
17P 
17M 
17M 
17M 
17P 
17P 
17P 
17M 
17M 
17M 
17M 
17M 
17M 
18P 
16M 
16M 
16M 
16M 
18M 
16M 
18M 
16M 
19P 
19M 
19M 
19M 



MEDPAR Listing of Twenty-Three Major Diagnostic Categories 

and i j 

Listing of DRGs with Abbreviated MEDPAR English Descriptions 

❖MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM AGE <70 W/L DX2. 
INFECTIONS » FEMALE REPRODUCTIVE SYSTEM 

MENSTRUAL & OTHFR FEMALE REPRODUCTIVE SYSTEM OlSURUtKS 

❖ CESAREAN SECTION h I T H DX2. 
❖CESAREAN SECTION W/G CX2 . 
❖VAGINAL DELIVERY WITH DX2 
❖VAGINAL DELIVERY W/G DX2 

VAGINAL CELIVERY WITH STERILIZATION AND/OR D£C 
VAGINAL DELIVERY WITH C.R. PRQC EXCEPT STERIL AND/LR DLC 
PQSTPARTLM DIAGNLSES W/Q O.R. PROCEDURE 
POSTPAR TLM DIAGNOSES WITH O.R. PROCEDURE 
ECTOPIC PREGNANCY 
THREATENED ABORTION 
❖AECRTION W/0 DEC 
❖ABORTION WITH C£X 
FALSE LABOR 

❖OTHER ANTEPARTUM DIAGNOSES WITH MEDICAL COMPLICATIONS 
❖OTHER ANTEPARTUM DIAGNOSES W/C MEDICAL COMPLICATIONS 
NECNATES, LIED OR TRANSFERRED 
EXTREME IMMATURITY, NEONATE 
❖NET IN USE FUR MEDPAR DATA SET 
❖PREMATURITY 

FULL TERM NEONATE WITh MAJOR PRCBLEMS 
NECNATES WITH OThER SIGNIFICANT PROBLEMS 
NORMAL NEWBORNS 
SPLENECTOMY AGE >=18 
SPLENECTCMY AGE 0-17 
OTHER O.R. PROCEDURES CF THE BLOOD 
RED BLOOD CELL DISORDERS AGE >=16 
RED BLOOD CELL DISORDERS AGE 0-17 
COAGULATION DISORDERS 

❖RETICULOENDOTHELIAL E IMMLNITY DISORDERS AGE >=70 AND/OR DX2. 
❖RETICULOENDOTHELIAL £ IMMUNITY DISORDERS AGE <70 W/U DX2 • 
LYMPHOMA OR LEUKEMIA WITH MAJOR O.R. PRCCEDURE 

❖LYMPHOMA OR LEUKEMIA WITH MINOR O.R. PSOC AGE >=7C AND/OR DX2 . 

❖ LYMFHOMA OR LEUKEMIA M TH MINOR O.R. PROCEDURE AGE <70 W/C DX2 . 
❖LYMPHOMA OR LEUKEMIA AGE >=70 AND/ OR DX2 . 

❖LYMPHOMA OR LEUKEMIA AGE 18"69 W/G DX2. 
LYMPHOMA OR LEUKEMIA AGE 0-17 

❖MYELOPRCLIF DISORD OR POORLY DIFF NEOPLASM W MA J C.R.PROC C UX^. 

❖ M YELOPRCL IF DISORD OR POORLY DIFF NEUPL W MA J U.R.PROC W/0 DX2 . 
MYELOPRCLIF DISORD OR POORLY DIFF NEGPL WITH MINOR CR.PROC 
RACICTHERAPY 

CHEMOTHERAPY 

❖HISTORY OF MALIGNANCY W/0 ENDOSCOPY 
❖HISTORY OF MALIGNANCY WITH ENDOSCOPY 

❖OTHR MY ELCPROL IF DISORD OR POORLY DIFF NECPL DX AGE>=70 C/OR DX2 
❖QTHR MYELCPROLIF DISORD OR POORLY DIFF NEOPL DX AGE<70 W/0 DX2 . 
O.R. PROCEDURE FOR INFECTIOUS I PARASITIC DISEASES 
SEPTECEMIA AGE >=16 
SEP TECEM I A AGE 0-17 

POSTOPERATIVE C POST-TRAUMATIC INFECTIONS 
❖FEVER OF LNKNOWN ORIGIN AGE >=70 AND/OR DX2. 
❖FEVER OF LNKNCWN ORIGIN AGE 18*69 W/0 DX2. 
VIRAL ILLNESS AGE >=16 

VIRAL ILLNESS L FEVER OF UNKNOWN ORIGIN AGE 0~17 
OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES 



£ BLCOD FORMING ORGANS 



it 



O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS 
ACL T E ADJUST REACT £ DISTURBANCES OF PSYCHOSOCIAL DY SFUNCT 1 UN 
DEPRESSIVE NEUROSES 
NECROSES EXCEPT DEPRESSIVE 



202 



! 



428 
429 
430 
431 
432 
433 
434 
435> 
436 
437 
436 
439 
440 
441 
442 
443 
444 
445 
446 
447 
448 
449 
450 
451 
452 
453 
i 454 
455 
456 
457 
456 
459 
460 
461 
462 
463 
464 
465 
466 
467 
466 
469 
470 



,MDC 

,MDC 

,MDC 

,MDC 

,MDC 

,MDC 

,MDC 

,MDC 

,MDC 

,MDC 

,MDC 

,MDC 

,MDC 

tMOC 

,MDC 

,MDC 

,MDC 

»MDC 

,MCC 

,MDC 

,MDC 

tMOC 

,MDC 

,MDC 

,MDC 

tMOC 

,MDC 

,MDC 

i MDC 

,MDC 

i MDC 

,MDC 

,MDC 

tMOC 

,MDC 

,MDC 

,MDC 

,MDC 

,MDC 

,MDC 

t 

t 

t 



19M 

19M 

19M 

19M 

19M 

20 

20 

20 

20 

20 

20 

21P 

21P 

21P 

21P 

21P 

21M 

21M 

21M 

21M 

21M 

21M 

21M 

21M 

21M 

21M 

21M 

jJM 

22 

22P 

22P 

22M 

23P 

23M 

23M 

23M 

23M 

23M 

23M 
>;« >,i 

»;« >)< 

>*< >'c 



DISORDERS CF PERSONALITY I IMPULSE CDNTRDL 
CRGAMC DISTURBANCES fc MENTAL RETARD AT I CN 
PSYCHOSES 

CH ILCHOQD MENTAL D1S0RCERS 

OTHER DIAGNOSES OF MENTAL DISORDERS 

*NCT IN USE FOR MEDPAR DATA SET 

DRUG DEPENDENCE 

DRUG USE EXCEPT DEPENDENCE 

ALCOHOL DEPENDENCE 

ALCLhOL USE EXCEPT DEPENDENCE 

ALCOHOL C SUBSTANCE INDUCED ORGANIC MENTAL SYNDROME 

SKIN GRAFTS FOR INJURIES 

WOLND DEBRIDEMENTS FOR INJURIES 

HAND PROCEDURES FOR INJURIES 

♦OTHER O.R. PROCEDURES FOR INJURIES AGE >=70 AND/OR DX2. 
♦OTHER U.R. PROCEDURES FOR INJURIES AGE <70 N/0 DX2. 

♦ MULTIPLE TRAUMA AGE > = 70 AND/OR 0X2 » 

♦ MULTIPLE TRAUMA AGE 16-69 W/U CX2. 
MULTIPLE TRAUMA AGE 0-17 
ALLERGIC REACTIONS AGE >=18 
ALLERGIC REACTIONS AGE 0-17 

vTCXIC EFFECTS OF DRUGS AGE >=70 AND/OR DX2. 

♦ TCXIC EFFECTS OF ORUGS AGE 16-69 N/0 DX2 . 
TOXIC EFFECTS CF CRUGS AGE 0-17 

♦COMPLICATIONS OF TREATMENT AGE >=70 AND/OR DX2. 
♦COMPLICATIONS OF TREATMENT AGE <70 W/0 DX2 • 
♦OTHER 1NJLRIES, POISONINGS 



♦OTHER INJURIES, POISONINGS 

DATA SET 



I TOXIC EFF D I AG AGE > = 70 AND/OR DX2 
C TOXIC EFF D I AG AGE <70 N/0 0X2. 

♦NCT IN LSE FOR ttECPAR 
EXTENSIVE BURNS 

NON-EXTENSIVE BURNS N1TH SKIN GRAFTS 

NON-EXTENSIVE BURNS NITH WOUND DEBRIDEMENT L OTHER O.R. PRUC 
NON-EXTENSIVE BURNS w/0 O.R. PROCEDURE 

O.R. PRQC MTH DIAGNOSES OF OTHER CONTACT KITH HEALTH SERVICES 
REhAElLl TAT10N 
♦SIGNS & SYMPTOMS WITH DX2. 
♦SIGNS £ SYMPTOMS W/0 0X2. 
♦NOT IN LSE FUR MECPAR DATA SET 
♦AFTERCARE 

OTHtR FACTORS INFLUENCING HEALTH STATUS 
UNRELATED CR PROC 

PDX INVALID AS DISCHARGE DIAGNOSIS 
LNGROUPABLE 



203 



_5 s 



E 
<e 
k 

m 









c 


1 


© 






1 




to 


"> 






01 


•5 










VI 


n 


s 








k 








01 












*£ 




e 




<© 




«=> 


















i. 




3 




"© 


s 


01 


: 


u 






in 


e 




a. 


u 




a> 


CX 


e 


o 



<*- te ■© 
o c 
e <c 

oi 

u m 

C Iflr- 
0) k 

w au 

£> &J 5 
IB Ck£ 

B. 
1. n v 
o»— o 

0) 0) V) 

u k c 

C 3 O 

ai "d 

l/l 01 *» 

« u a 
ton 

Q L U 

CL X 
0) Oi 

5 § oi 

e i. *j 



10 

k VI 
01 (-> 
Q.O 
O X 



<»- i- in 

«»- 

01 c • 

— *r 
c ^ 

01 l/l 

(A k • 

01 « CVJ 

k 01 o 
a. a. 

too 
© => s 



k o o 

01 

>*->(/> 
o <o c 
u o 

k 

o — *> 
a, 

f tin 
rv O UM 

U X 

01 01 ^ 

er k c 

■O O 01 10 

c • 

O 4-> CM 

f CM 
e ■© *» 
o i- * 
— .© * © 
v> k (\j 
•>- o w 



CM 

01 £ -o 
y io e 
c oi e 
01 o. 

VI O. • 
£ «N 
10 

k c • 

© © <3> 

01 S *~ 
U « • 

C UN 
0» — — 
VI p— 
01 Q. • 
k f « 

a. 5 © 
u 

0) > 
£ klA 

•*-> o o 

E *■> * 
o *> <• 
o 

c 

o ■»- • 

.a CSJ 
VI k O 

> 

•DUO 



<o 
e oi 
•«- e. 

k Q. 



O k 
* § 



« k 

C Ql 

v> a 

c! 



5g 

*» 5 
e u 
o 

i/i 
e ■»- 

o l/l 

©> 

> *u 



o 
u 
o 



01 



k 

£ 

01 

<§ 



k 

01 
4-> 
10 
0) 

k 

(9 



i. 

01 S 
c Q. 



C 3 
•P" "© 

in 0) 
u 

> o 
~- k 

■D ft 











1/) 








o 




w 




— 5 
















CL 




CL 




c 




c 


cl 








u Cl 


c 


c to 


C 


C 10 










k c 








Cl AO 




. ^ 






y 






J -= & 


*T ^™ 


ct 


^_ o 


5^ 


W 


o Cl 


O 














w 


w w 








O fO 






F 


c **— 






(L> »~ 


flJ c 




I/) 




</) *^ 






^3 O 






•v 


to 


<0 ^ 


9 






■0 




4. 


v o 


Lb 






o 


O 




O 












a> id 


vv w 








E y 


t= © y ^ 


c c 


c o 
















!T ■ 






_ 


w 






w w 




cl o 




Cl 


Cl*J 








3 


Qj ID 


flj e e 


at *5 




• C 






•C ID 














*■ 




o 


cow 


C w 


iT 

c o 






O 


O 






V) 




§ To 




? 


c «^ o 












*»~ w «w 




•f- O <J 


V* c 


(/> Cw 












Cn 2. 


> ID 


"> *o' a* 


> -o 


> 10 








"P" c 




^ ^ 4-> 




"O 


■ 


a 


It 


II 



r 



w 

OI 

e 

01 



k 



O OI 

_ o 



r— C 

£ - 

k « 

o 



0) 



01 

£ 

l/l 

o 

I 

o 



o? 




204 





























k 




•c 




> 








« 




f 




4-> 




<*- 




o 




J? 








l/l 




10 




X) 




01 
















o 












q_ 




•T 








l/l 




l/l 




ID 




X 








c 




z 




c 




n 




c 








f— 
























e 




01 








4-1 




n 




a. 




i*- 




o 




n. 




3 




o 


O 


k 






JE 


k 


u 


ID 


CB 




% 


3 




U 


k 




© --y 


«<- 


k 




10 


wt 


o. 


VI 






10 






© 




2= 


§ 


Q..C 


e 


er 


s 


c 






a, 


*» 


s 


10 


O 


u 


k 








c 


01 










l/l 






01 

=© 




k 


t 


u 


VI 


l/l 




OI 


l/l 




3 




O 


© 






k 




*0 


01 


> 


rv 


01 


01 JC 


m 


*J 


VI 


*» 


E 


u 


(C 


OI 


k 


c 


cn C 




o 




«J 


£ 






in 




01 


0) 


e 


k 




r- 


— i 



CM 

















>■ 

§> 




(/) 


It. 


re 


c 


re r» 


re 


re 5 




o 


o 




o 


o 








c 




<*- »— • 


It- — 




i». 




O 


OI 


Ol k 




o 4-» 


o o 


o 


O 01 








© 


u 




re k 




01 

u 




C 01 


Ol 


01 » « — ■ 


01 X 


01 c 3 


01 in 




01 o. 


U <_> 


o i~ ve 


u 


o k E 


u re 






in O- 


e o 


C 4-> o 


c c 


c oi S 


C E 


t>sei 




^ re 


Ol X 


01 X 


Ol — 


Ol +■» «*- 


01 




re ■ — - 


in 


in Oi O 


VI 


m e 


in *~ 


o. 




X) c 


_C5 o 

«» £ 


^ 1/) 


Xl -r* k 


£ re 






k re 


re — 


re k 


re o 


re *> 




u 


o -- 




re 1 


re 


«. 


o 


or 


c 


c 


k in 


k *> c 


k Ol 


k O CL 


u *5 




oi k 


O k 


O C «r- 


O CL 


o 


O -O 


"k 


U 0) 


re 


01 


CL 


v — JC 




01 

u 


o. 


C X: 


01 Ol 


WO V) 


Oi re 


Oi re 


01 in 




Ol 


u o. 


o k 


<j«— » 


u > 01 


U 




- 

re 


V> ' — 


c a 


c tu 


c 


c or 


c •te- 


resei 


oi re 


oi re 


01 O Ol 


Ol X 


01 E 


ai o 


k k 


in «w 


VI CL 


in E 


in 85 


in 


3«-^ 


CL © 


01 


Ol 01 CL 


oi S 


ai k <♦- <— » 


Ol 


( i la 


M 


k 01 




k 4-> 


L. o CO 


L. CTi 


a. v> o 


o> o* 


a. l. 




CL u 


CL k O 


Cl in O 


■C 


r 




01 


O in 


O 


the 


In MOC 


4-> 


01 "D 


oi oi c 


Ol 4J 


Ol Ol o 


Ol CD 


•© 


f 01 


f u o 


f in 


■C C U © 

*» o~-x 


JZ COO 

*» re X 


c c 


4-> U 


♦> o «*- 


4-> >, 




o re 


o 


L. 4-> 


u 


— > 




on 




e t. 


c t re 


C 01 


C in ai C 


CD c 


c ^-^» 


O CL 


o k 


o 


O i- "© 


o 


o 

in 

X 1. 


o re \o 




o 


o 


o 




E 
© 


f c © 


C OS 


e re 4-> 


C -C 


c x e m 


c re in 


m 


© © 


O CL in 


o u 


O 01 o t» 


oaL 




a> re 

f— 0) 

CL Cv 


t- 3U 




t- Ol 




re 


^ re 


W 


> 0)0 


in k 


VI U L 


in 


in »— ♦» ai 


in u Oi 


— ex 


— o 


C 


— re 


re re cl 


i- C Cl 


s& 


€ B- 

© re 






^ ^3 




> U X CL 


> CL 




C 


•»- re 


— ■ k c 


— o 


•«- O — re 


k re 




u 


rewi- 


■o E 


■o ait 


T3 4-> 


■o «- ' 


T3 CL<— 



re 



k 


01 




4-> 






k 




u 




1 


3 




Ol 




Ol 






*» 




Ll. 


Ol 


"O 


in 






u 


c 




k 


"O 


o 


re 


2? 




c 


k 


c 


01 




re 


Cv 


c o 










o — 


*o 


Lv 




ce 


~- 4-1 






re 


o 


♦» « 


u 


TJ 


c 




O k 




e 




k 


re o 




re 


*3 


o 


k ■*-> 


re 




ai 


">-J 


■*■> in 




a. 


c 


re 


x oi 


o 






X 


lu ce 







o 

4-> 

u 

01 

4-1 

in 

£ 

re 

4-> 

o 

4-» 

XI 
3 





205 



TO 



a> 

CD 



-a 

CD 
CO 



o 



o 



0) — 

u 

C </> 

ai k 





t/l 10 


1/1 




.0 01 






<D CL 


IO 




a. 






k to 


k 











01 c 


01 




u 


u 




c 


c 




0) l/l 


01 




«/> 


«1 




0) U 


01 




k X 


k 




O. 01 


Cl 




0) — 


01 




JC IB 


JC 






4-! 




O 






c ■— 


c 












k 






c 


c 


o 








=a 


>> 




E 


in in 


to 


§i 


— a. 






> 


> 








01 


•O 




°o 












t/1 


II 


It 


c 












k 


e 




<e 







ai 






Q. 


in 




a 








u 






X 




c 


LU 


e 


<0 




s 


u 








(0 


4-> 




u 


CL 


C3 





3 


J= 


_J 


k 


I— 




k 




"O 


o> 


Ifl 


e 


<-> 


C 


« 


s 


e 








>> 












CL 


« 


O 







aj 




3 


e 


m 


t— 



a. 

u c 



k « 

o. u 



jo 

* k o 

.0)0 

o 

r c * 

10 ie 
>■ — • 



9J 



<»- 0) 

e *- * 
o S 

- Si 
» £« 



jc 01 
*j u 

— o 

*I 

01 o 
> 

— 01 






































it. — 
£ 


O 


O v> 


a," 








01 IA 


ft) 


ftl fTi _» — 1 






U 


^ ir> 








ft) g 














*£j re 


pi ' 


£ s- 




a 












^ " 




L. w 
« ^ C 




(j 


O 


O c ^» 


0. t 


0) ^ 


Of 


OJ 10 








» *^ " 








?. O W 


o> 


01 


0) 


4» Q; 








JfJ V» Cl 




0) 






sM 


u 


ft 4/1 *° 








o) E, 
j= ST 


aj ?! 


(1) 




J= n 




f- ^* g 




k 














^ 


O 







g- 


»- • 


c 


- " = 




§£■ 















i § 








» g 








>T 


> 




=5 •* 








5 tt 







II 



o. 

« > 



2? 
« 

■o 
c 
o 

u 
at 
00 



01 



</l. •*- 



a> 0) 
10 *» 

5 g 

o 

t— 0) 
10 z 

fi. 

^- 0) 
U f 
C 4-> 



L. 

c 

01 ~~ 

U W> 

C i- 
01 <0 

<n a> 
ai o. 

I- CL 
CL IO 

01 

£ c 
*j i~ 
o 

C XI 



I/) 10 

— o 



ClQ 



— 

0) v> 
U k 

F « 

01 ai 
<A Cl 

s- 

« 10 

I.*""" 
ct 

01 o 

C cn 

a> © 
in -o 
01 c 



■»- 01 

tfl (J 

> £ 



M 






u 


4J 








3 








S 








c 


k" 






- 


10 














5 


£ 








© 






in 


U 






E 


01 








(/I 
























c 






X 


10 


V) 






u 


01 








in 







s= 


O 









c 


m 


E 


E 


01 


O 




o> 10 




z 






c 




LU 



OJ 

m 

JD 



V) k 

O 

IO 



k 01 

o u 



00 



CD 



i 

vi- 
O 

c 
o 




206 



2 

IS) 
Ol 



o> o 

u 

c >> 
01 U 
VI C 
X- 10 
to C 
O. 
k •«- 
Oi— «~ 

«J (SI 
* E — 
O 

c <*- o 
woo 

VI Z 

k c 
C m i- 
O 

t> e m 

*-> IO <o 
i- Ol 
C IS o. 

o a. 

e « >— 
o o. 

in u v 

c +* 

>-»-(/> 

~- k o> 
■o o.*j 



VI 

<*- k 

01 o a 

U 01 

c >> o. 
« u a 
vi c « 

JQ "O—- 

<o c 

k.?f 

•— ** 
to VI 

01 E >> 
u VI 
c <*- 

01 o Ol 
VI > 
01 vi f- 

k — 4J 

am u 

O 3 

oi e "o 
JC o- p 

■M 10 k 

o. 

CO CI 

o k«— > 

r— (M 

c <e oi >— 
o a.— 

C Z 

> f- Ol 

— k x e 

■O Cl+J ^- 













VI 


















10 

u 






VI 

o 


<*- c 


V- (_> 






«•- c 


<*- u 


O w 


O Q 


o z 


o 


O i- 


O 3 




X 




k 




Ol 


01 O vi 


01 


oi e 


Ol o 


Ol VI 


Ol c 


u k 


o e 


o ■<- 


u 


U k 


u 


c >, <e 


C T- 


c 


c 3 


C IO 


C 01 


01 U Ol 


01 


01 l/l 


oi E 


Ol a> 


Ol > 


m c a 


I/l VI 


VI k 


l/l o 


vi Cl 


VI •— 


XI • Cl 


XI k 


Xl IO 


X) x 


XI CL 


XI VI 


to c a 


a to 


IO Ol 


09 Q. 


«B 10 


IO l/l 


o*-» 


Ol 


Cl 


E * * 




01 


t» — 


s- a. 


t~ a. 


k 5,r>» 


u 


t- k. 


O— E 


O Cl 


O IO 


O^- 


o o 
S 


O Cl 


s s 


to 






Oi 


oi E «-> 


01 w 


0) 


01 <*- o 


Ol Ll. 


Ol "O 


u in 


u 


u c 


o o a 

C X 


u 


O 


c <*- >, 


e c 


c o 


e <*- 


c <*- 


01 O i/l 


Ol o 


Ol — 


01 VI 


01 o 


Ol o 


VI 


VI "■- 


VI VI 


vi f e 


VI 


VI 


0) vi Ol 


Ol *-> 


Ol VI 


01 VI "l- 


Ol V) 


Ol VI—-. 


I- — > 


i- 


u 


k o 


U f- 


i. •»- o> 


a. vi ■»- 


a.*o 




ac vi 


O. vi 


Cl vi 


O *J 


c 


■6 


o-. k 


o 


O 


oi e u 


01 o 


01 IO 


Ol IO IO 


Ol c 


01 CD 


X Ol 3 


X u 


X 


x: — « 


X 9 


X OlO 


*> «-o 


*» 


** VI 


♦j "o a. 


*J IO 


*» io X 


o 


E 




a. 






e "O k 


c 5 


e x 


C «— 10 


c ^ 


c°o e 


o o. 


O 4J 


O *J 


o « • — ■ 


o 


o 


•— 01 


s> 




cl 






e«v 


c «e 


e >, 


C 10 


C 10 


c * in 


O Cl ■ — . 


o a. 


O k 


O U t- 


O Cl-~ 


O Cl k. 


■«- ~- 01 *n 


■*-> 


■«- 01 


C E 


f 00 


— IO 


VI O i— i— 


VI l/l 


VI > 


VI 01 


vi y» 


VI U Ol 


«•- c <o 


O 




k j£ 




c o 


> Cl 


"> f— 

— 01 


> CL 3 
-«- 01 


> Cl 
— fc. io 




•o IO 


"O "O 


"O • 


■O CkX 


^ Cl«^ 



OX) 



cu 

CD 



-a 

a> 

00 



o 

J=3 



o 

Ol 

o 



10 

o 

>— u 

•0 c 
Cl 10 

c 

u cr 
c — 



Oi 
10 

o 

- & 

« c 

CL to 
f c 

u oi 



o 

l/l 
VI 

o 
c 

Ol 
10 

5 

to e 

Cl io 
C 

U Ol 



5 I 



i5 



1- VI 

io o 

CL C 

*» o 

VI « 

o = 



VI 

"vi £ 
O -x 



o 



II 

a. _j 



o 

VI 
VI 

e 

01 if 



c oi oi 
•*->■*- 

k Ol k 

a. u_ o 



l/l VI 

— Ol 

VI l/l 

o 

C k 

01 3 
IO 01 

— z 
o 

Ol 

p— > 

« — ■ 
Cl vi 
f- vi 
U Ol 
C k 
-r- Cl 



CO 



5^ 
CD 
^£1 



O 
Xi 

S 



k 

Ol 




207 



o 



00 

E 
en 

ah 
ro 

o 

CD 
CD 



■a 

CD 
00 



o 

-O 



1 51 



00 



<e ©> 


Ol 


o 


m 










01 in 


in 


c 


e 


*J c 


&» 










£ k 


k 


**- 


**- 


t^ IO 


<4- IO 


*^ 




^ z 






H- IO 


o *> 


o *■> 


o a. 


© o> 


o 




o 


© 


01 


O © 


to 


■a 


01 •/< 


a. 










<*- a. 


Q. 




01 »— 


0) £ V 


Ol Q. 


01 


O 


01 o •»- 


01 


© ©. 


© D. 


u © 


U 0) 


u <e 


u to 


u 




u 


u 


10 


U IO 


c u o 


c w 


c <*- 0) 


C w 


c 


>> 


C >) in 


c 




c »— » 


01 


01 


01 O Q- 


Ol 


01 


u 


ai u u 


01 


u 


© 


S ^ 


W tn 


in a. 


m e 


1/1 


e 


in c io 


in 


e k 


in in 


=Q ~ 


£l 


>» io 


.e o 




n ' — - 


•O >0 01 


& 


IO © 


•© 


IO in Z 


t0 tn 


<o 


© 


to 


c en 


<o c o. 


IO 


c ^ 


io in 


o 


O 


i £ . 






OiO 


01 a> 




©1^ 


. >i 


k c c 


2= C %B 


i> « m 


k 9 


k 




k v IO 


u 


^ 10 


k »- 


o ©>-^ 


O ©i© 


o c « 


o e 


o 


r— k> 




o 




O a 


to 


<e 


©1 01 


10 




<e o 


IO 




m A 




© ■»» in 


81 k) 


0) k 


01 V 


Ol 


E Z 


oi E m 


01 


E k 


© ^ 


U T3 ^ 


(J O 




u 


u 




u 






© 


C « 


c z 


croc 


e 


c 


>*- e 


C **• *J 


e 


«*- o 


c 


© t"" 0) 


0* ^— 


0) E © 


01 o 


01 


o — 


41 O 


01 


© -0 


© o 


(/) IQ & 


(A V C 


VI D. 


i/i 


tn 




in *~ 


in 


IO 


in 


© a. a. 


© Ci. t— 


o> «/l 


oi in 


01 


in in 


Oi in s 


Ol 


vi E 


© in 


u a 


k 


k ^ 


k 


£ 


■«- k 


Lb «^ ^ 


u 




k **" 


& o — 


& U M 


& V) C 




a. «/i m 


&. tfl 


Q. m "O 


©. in 


c 


C k 


o to 


o 




O 01 


O 01 




O c 


o 


01 — >, 


0> IO 


© c 


oj s 


01 


c o. 


o> c u 


0) 


e io 


© c 


* *■ E 


£ k 01 


£ 91 E 




•c 


cr> a 




JC 


©i 


JZ ©l 


*-> Q. O 


« a a 


4-> to 0> 


4-> IO 


*j 


IO IO 




*J 


10 k 


•*-* 10 


•J 


a. 










° 




-- © 




c ■© u 


© *© IO 


C 13 m 




C "O 


s = 


c 


■o *» 




o o> 01 


o G; * — 


O >» 


o 


o 


*•> 


o t- 


o 


0)*-* 


O *~» 






i— «/) 


» — co 




»— m 


Ol 








e a c 


e <o k 


e <o 


e io o 


e 


<o « 


ecu 


c 


to © f— 


c « •— 


O © © 


o u © 


o a. >>^^ 


o o. 


o 


a. oi 




o 


a. 


O Q. 


•»-— o. 






o 




^- u 


s 












In "u » O 




i/i 


U ^3 




in 


"u ©"^ 


o 


••- *c. io 


11! 




■S c z 




C 


t- C C 




c ez 


-p- c z 








> 1- 


> 


0) 


> — f 


> 




> ■»- 


£§© 






•<- k c 






— k. ^ 




k •«- C 


k c 


■© u +j 


■© U *J 


•o B..O z 


^ 






^ a. in 




©.^ — 


^ ©.— 


n 




n 


n 


M 




n 


a 




It 



<<-> 






*. 






«- 


•*> 


>— (J 




o 


o 


© 




o 


o 


IO © 


■o 














©.■© 


a. 


in 


in 


in 


in *3 


in 


in 


f- c 


— k 




^» 










u © 


u © 


in 


in 


in 


in ' — 


in 


tn 


c a. 


c o 


O 


O 


o 


O © 


e 


o 


— Q. 




c 


c 


c 


c u 


c 


c 


k «c 


k ~ 


©1 


01 


©i 


© 


©> 


©1 


o. 


o. 


IO 


m 


© 


<o k 


10 


■o 


I«> 


Ik 














■o © 


TJ O 


o 


o 


o 


5° 


o 


5 


© 


© 


>> 






k 






*J m 


*-> m 


•— U 






f— Ol 






«e — 


n **- 


IO c 


*I0 C 


<o e 


© o 


« c 


to m 


u m 


U m 


Cl io 


CO 


a. io 


©.>— 


©. to 


0.1- 


— © 


O 


f- e 




•f c 


-p- ra 


i- e 


i- in 


•— C 


I— c 


© ©> 


o *— 


O ©1 


u 


O ©1 




Q. ©1 


Q. ©> 


c 


C ©1 


e — 


s = 


a = 




S © 


E io 




•<- e 








^ © 






"k *« 


k a 


11 


*k ^ 


"k *io 


k 


k) o 


o 5 


a. z 


a. ts 


a, i/i 


a. s 


Q. O 



CO 



CD 



oo 

•»- 
o 

c 
o 



g 




208 



CD 



03 
Q3 



■o 

CD 



o 

-O 



© 

I 

41 











c 






in 




l/l 

l/l 






>» 




o 


VI 


<*- c 










© 


k 


e 


• 


O k 


o 


o *» 


o 


C 4-> 


CM 




« 


o 




10 








41 IO 


4» CM 








VI CL 


01 41 


0> VI 


0) o> 


01 


*-* 


u 


o 


c 


k O 


•m 41 


O Cl 


u k 


u c 


u 


** l/l 


Si !*? 

CD o 


e 


o 


VI u 


C O. 


C ID 


e — 


C ll. 


ID 


41 


o 


<0 Z 


o x 


41 io 


41 41 


4* C 


4> X 


Cl 01 


i/i X 


VI 


V 


ai «-» 


C 41 


«/>«-*• 


l/l CL 


S3 $ 


VI k> 


V 


.o 


.o 


v> 


O. ro 


9 


JD 


■O cl 


.n E 




41 k 


<e c 


<0 




& O CM 


io Qi 


10 10 


•B IO 


10 


IO k 


f «B 






>,eo 


io 




. E 




r— 




*-> f 


k 


w 


C CM 




*u 4J 


k S 


k 


k IO 


k ° 


u 


O VI 


o 


10 


o c 




O 10 


o < 


O k 


° S: 


4J VI 


k 




o 




^- £ 


k 






01 < 

u 


o f 


01 io 


V 


VI O 


4-* 


W 4J 


41 4-> 


41 H- 


41 > 


e ^ 


u oi 


u 


« z 


1 Cl » 


a.— 


U 


U 


U 




C CL 


c 




O 41 CM 


— X 


c <^ 


c **- 


e **- 


c 


k e 


at a. 


01 


>» c 


U CM 


u 


41 O 


41 O 


41 o 


41 O 


o o 


(/> 10 


VI 


O 


• X 


C VI 

k O 


VI 


VI 


VI 


VI 




41 w 


01 


c 


+ * • 


41 VI 


41 VI 


41 VI 


41 VI 


k ^» 


k 


w 


a vi 


00 o 


k 


k ^ 


k **"■ ^» 


L- LO 


41 41 If) 


a. c 


& 


C k 


r— 41 CM 


ClZ 


Cl in 


Cl vi 


Cl i/i O 


Cl vi O 


£ VlO 


w 




CT 10 






O 


O 


O 


O 


4-> 10 


a> s 


a> 


41 


41 « 


0> »~ 


41 C 


41 C 


41 C U 


41 C O 


f o 




•c 


Ql 


en en 






£ CFI 


JZ Cr. O 




4J 


*> 


5 °- 


*0 «c 


IQ 




** 10 


4-> A3 Z 


4-1 n Z 


* ^ z 


* 




E « 














ID 


c > 


c 




C • 
O IK) 


c c 


c ■© 


c ^ 


c *o c 




C 41 C 


O 


O H- 


o ^* 


o 


o 


o — 


o — 


O "O 


VI 




O VI 




in 




^» 


*™ 






c c 


e 




C vi 


E W 


C CO 


C 


C 10 VI 


C IO VI 


e k vi 


O 41 


o 


>»T» 


o o * 


O k 


O Cl 


O CL^^ 


O CL k 


O Cl k 


o o k 


4-> 




k o 


o ^ 


IO (J 






■p* 10 


— — « 


IO 


tn X 


VI 


o c 


vi x ■— 


V) 4) O 


MUG 


VI U O 


l/l U (1 


vi O 41 


VI 41 41 






*j en 




Ct Z 


— c z 




g Q_ 


C Cl 




> 


> 


vi <e 


> «— • 


> CL 




>««-«-> 


> Cl 


> Cl 


> — Cl 


e 






— — cr> 


i- 10 «♦- 


^k c 


— k Q 


k IO 


v k 10 








^ io — 


^ — o 


"© CL — 


■o ClZ 


•O Cl— ^ 


"O CL— 





3 
CO 

01 

> 



>> en 

U IO 

e 

St 



s 

O 01 

o c 

■u 10 
i/i 

->- VI 







•*> 


lt- 






o 


o 


VI 


i/i 


l/l 


VI 






— u 




VI 


i/i 


l/l — 


VI 


o 


O 


O E 


O V) 


c 


C 


C 41 


c 


er 


o> 


en^ 


er*-> 


•o 


10 


« u 


io 








— cr. 


o 


5 


S « «" 


a e 












t— n 


— *» P 


r- C 


IO 




<o c«— 


« 41 


CL 


ai 


Cl 41 


CLZ 




a 


— — • 




"o 


U k 


U VI U 


u >— 


e 


C h- 


c c io 


c « 






— IO 4-1 


k 


k 


k M- 


k k 4J 


k — 


Cl 


CL O 




Cl. > 



c 
o 

4J k 

u- fc* S 
O « Z 

vi e ai 
— ■ > 

V) 

O »- 4J 

C <0 V) 

en— 4i 

IO ^ CTk^ 
= k C U. 
O io O X 

u o o 
— o — 
« >, k 

CuZ O Ol 

"o 41-^ 3 

t- 3 Z — 
L U4 « 

a. < wu. 



CO 

o 

4— ' 

>, 

CD 



V) 

u 

01 

o 




209 



DO 

03 



a> 





0* 












u 












c 




XI 




vi en 


**- 0) 


>»- 0) 


<*- CM 


<*- 01 


1 — 


k o 


O U 


O "O 


O C CM 


o — 


o 


io o 


c 


c 




XI 


p 1 


0) X 


0> 0) 


0) 0) 


" - 


0) 


k s 


Cv 


u -o 


u a 


(J o o 


(J k 


k 


Cv«- 


c c 


C 0) 


e *■> 7L 


c o 


CT<4- 


<o O 


01 01 


01 XI 


01 


01 


c 




V) a 


VI 


VI X> C 


VI X) 


T- k 


1/1 


.O 0) 


.fit— 


JO 0) 


.£> 01 


*» 01 


01 c 


<a xi 


<o o 


« k 


e k 


«S XI 


in O 




JC 


k VI 


k 


k k 


3 f 


k Ol 


k O 


L II k 


k 01 


01 o 


*» 


° ? 


O (J 


O <0 


o «•- 


a 


0) Cv— « 


u 


I 


VI 0) 


VI 


o •— 


u gin 


0) xi 


0) 10 


wee. 


01 c 


10 


k UN 


u 


u 


una 


U 10 


<«- u 


3 X 


c <*- 


C H- 


c k io 


C k 


o 


O Ol XI 


0) e 


0) o 


<D 4-> • • 


01 4-> 




VI C 




VI 


VI 


1/1 


01 o 


oi ai io 


oi v> • — ■ 


Ol VI 


01 <*- >t 


01 <*- *— 


Cv k 


k JE 


k — ■ O 


k — © 


k O •«-> 


k OKI 


>, «o 


4-> O 


a. i/> cm 


O. t/i esj 


Cv •»- 


Cv — 


*■> k 


C CM 


o 


o 


VI • — 


VI 


0) 


O f 


ai cu 


01 c o 


ai 3 — 




01 


4-1 • 


£ er>o 




.£ *» w 


£ *J O 


.e -C 


XI Ol 


*J ID E 


*j io X 


«> s c 


«I 


•4J 


« J- 






•fa) <*- 


*> 


c 


VI 


C 73 C 




C V) 


C VI E 


c 


io vi • 


O 


O i- 


O 01 


o 


o 


.o o co 


^» 




0) k 


01 




a «— 


c <c m 


C « </l 


c c>« 


C C VI 


c£ 




O Q. k 


o a. s- 


Oku 


O k k 


O 3 - 


i- ITS 


«0 


"•- <0 


IO IO 


>»- XI 


Oi»— r*. 


in U 0) 


VI U 01 


in f 01 


VI f 0) 


VI Of 




■■- c a 


■»- c a. 


U +» 


'VO. 


u 


Xlo*" 


> a 


> a 


> VI 3 


> VI Cv 


* s 




— i- «e 


— k io 




— i- to 




O C io 


x> a«— 


"O a«-~ 


xt xi n 


XI Xi»-» 


x> a 


*J 


ii 


n 


N 


a 


R 




u- 


<«- 


o» 

4-1 









•ir- 
es 



GO O 



(9 
O 



CL) 
CD 



CD 
CO 



o 

CO 5 



o 



o 
c 
en 



o 

01 

r— U 

<e c 
a oj 

•t- XI 

u c 
c oi 
a 

k 0) 

a. a 



o 

01 

•— u 
<o c 
a oi 



a.0 1 



o 



oi •— 

k T- 

k o 
01 <o 

«t- Lv 

1/1 

C 01 
ID k 
k to 

»— <-> 



w 

5 

k 
o 

XI 
0) 

k 
k 

01 



o 



XI 
0> 

o 
o 
k 
a 



CO 



o 

I 

o 

C 

o 



2 

01 



5 k 
O 0) 



Ol 

•*-> o 
io o> 

k 0) 
01 *J 

a is 
o u 



o> a 

IO 3 
f- O 
O k 

IO XI 
C 0) 




D 



210 



sajnpaooJd yO 
jaqiO Pup 




E 
cd 
-*-> 

>> 

en 

O 

CD 



3AJ3N IPjUP-Q 

puH |ej3qdu3d 




CO 

O 
a: 
Q 



O 
Q 



o 

cc: 

a 



ipuids 



Q 



ALUOJOIUPJ3 



00 

<• 




O CD 

oo o 

■4-1 >— 

<d 
-a 

V. 

o 

i/i 



O 
c 

<Jfl 

< £ 

r- Q 

a -a 

Li. < 



-a 
c 

rd 

CD 

rd 
CD 



QJ3 

c 
c 

g 

Q. 



3 



211 



w%- - 
Of 
C 
00 



O 

o 

0) 

u 

u 

O 
C 
OA 
CD .2 
r- Q 

S '# 
u= 2g 



E 

0) 

i/i 

1/1 
1/1 

o 
z 



o 

1/1 

a> 
-o 

o 

i/i 



T3 
C 

i/i 
<D 
i/i 
03 



sjapjosia 
jp|rDSBA0jqaJ33 



3l^p3dSUON 



sjapjosiQ 



jp|nDSPA0jq8J33 




pup sisojsps 3|d'!J|nw 



uapjosiQ 



O 




ujspjdoiN 




saunfui pup 

SJSpjOSIQ |EUldS 



2 

a 



00 

c 
c 

o 

'€ 
a. 



T3 

<u 



< 

u 
E 



II 

< 



a s 



212 



o 
o 

CUD 
<u 

w 



E 

1/1 
>« 

in 

o 
Z 



w 

Si O 



<J .2 



-a 
c 

03 



<U 




213 



o 

ao- 
jw 

re 
U 

jj, 

«J 

o 
a. 



jp|roopj}xg jaqio 



suai 



SU| /tlPLUUd 



O 

a 



< 



O 




00 

m 
O 

a 



is. 
m 

a 

a: 

o 

m 

O 
ee 
Q 



o 

a: 
O 



o 
a 

O 





O 


o 


c 




Cate 


rders 


'c 
o 

•E 




u 


o 


to 

Q. 












[SOU 


b 


edica 




OX) 


C 










-o 


CM 


5 


<U 


c 

re 


a> 


k. 


tn 


re 




o 






3 


cu 


SO 










iZ 


5 


b 


on 



o 

5b 
re 

Q 



c 



sjapjosig 



|PDi§0|OjnaN 



PUJ8L)dXH 



4> 
< 



O 
Q 





m 

O 
a: 



o 
o 



o 
a 



214 



Xluo}OoUuAw 



piouspv 
pue ||SU01 




piouapv Pup 
fisuol J3t|;o 





2? 
o 

00 



3. 

y 
O 



jeg pue 



'^BOJm 3S0M 

snoaueiiaosiw 



O 
Q 



to 
in 

O 
a: 

a 



cn 
o 

o 

<u 

U 
u 
!SS 
i/i 
O 

c 

00 



c 

a, 

o 
Z 

(T3 
LU 



on Q 

3 -a 

LU 5 



o 

<D 

o 
Q 

C 

<T3 



OB 
c 
c 
o 




O 
of 
Q 



Q 



O 
Q 



O 
in 

O 
Q 



>|D3N PUE pP8H 

jolew 



■e 

1/1 ro 
(D Q- 
v/1 _ 

On 00 



215 



419-177 



84 



15 




© 
o 

W5 
4) 

U 



O 

c 

CD ■— 

m Q 
V »- 
3 § 



o 



c 

CD 
O 



LU 

CD 

-C 

O 

ui 
k. 

CD 

T3 
k_ 

O 



c 

(T3 
I/) 
CU 
i/> 

CU 
1/1 



ao 
c 

g 

■E 

Q. 



-o 

0) 



o » 



'u 

ver ; . 

TC ■ 
0*, 



>■ .4 




siimo|Sid3 sC 



sixp;sid3 



ain|jq!|inbasX(] 



Q 



O 



a 



Q S 



216 




2* 
o 

«, 

U 

<u 

3. 

•o 

o 



sajnpaoojd 




in 

O 
a: 

a 



E 

<u 

i/> 

o 

n3 









o 








o 




W5 




<u 








u 




u 




'•S3 
i/i 




O 




c 






< 






5 


0> 




I— 




op 




iZ 


2 



CL 

a: 
<u 



o 

<U 
T3 

O 
i/i 



C 

i/> 
<U 
i/i 

O) 
i/i 



c 

'c 
o 

■E 
a. 



3 

00 



217 



o 
c 
so 

2- 

b- 
9- 

U 



o 

60 

<J 
u 
35 

O 
C 

co .2 

Q 

14 

y= it 



to 

on 

O 
Id 

w 

Q_ 

<U 



o 

O 



T3 

c 

rd 

rd 
<U 



00 
C 

'c 
g 

r 

a. 



§un-) |BiJ!iSJSju| 



Asunaid p U p 



emoLunsud a|diu;s 



astasia AjBuoujirid 



3Aipnj;sqo 3|uojq3 



9jn|jP-j 




/Oo}ejidsay pue 
eaiapg /tipuowind 



LUSP|doaiM 



SUOj^HUJLUeyu 



pue suoipa^u 



ujsiioqujg 
Ajeuoujiricj 



00 

O 
a: 

a 




Q 2 



218 



Q 
C 
00 



u 

c ■ 









o 








o 








<u 








U 




u 




53 




</> 




o 




c 






u 


fd 




Q 


<u 


k. 


o 


.1 






5 



E 

<u 

-(-I 

>, 
o 

-4-> 

i_ 
Q. 

O) 
C£ 
0> 



-a 
i_ 

o 

in 



■a 
c 

n3 

<U 
en 

1/1 



41 
C 

o 



00 

c 
'c 
g 

■E 

CO 

a. 



sssouSpiq j3l|;o 



saiojdaiXs pup suSis 



PLUL|;SV PUP S^ILjDUOJff 




xpjoqioainaud 




< c 










■o 








O 




u 




a> 






OS 




a 








Q 





O 
Q 



a s 



219 



• Si 





< 

I 

< 


■} 

1 


•„ t 

( 

( 


£ 

1 1 


1 

1 

- <. 

c 

( 


1 
3 

? 

; 




. . ;■. \.-- :: .- 






221 



O". 

■ c 

2 
Q 



in 
o 

^ 
o 

u 

u 

o 
c 

on 
<j .2 
in q 
<u >- 

3 .a 

iZ <£ 



222 



E 

>» 

o 

J2 

3 

u 

a— 



0) 



o 

T3 

O 

in 



c 

cn 
(U 



T5 
C 



c 
c 

o 





o 

at 
Q 



O 
ae. 
Q 

§ 

a 

ar. 
Q 



a 

a: 

Q- 



223 




224 




225 




15 

o 
■*-> 

Q. 

<V 

X 



o 

4) 

U 
u 

S3 
i/i 
O 

e 

CUD 

oo .2 



ppjlXjei|!g 



J3AI"| 




A3UEu3l|EW 



sH!JBd3H3!|oqOD|V 











at- 



puesisoqjJi3 



g~2 
O 



S'G) -3 
£"1 



T3 

O c 
Q °- 

=1 

E 

■ 93 

03 iyi 
a; >> 



oo 
c 

'c 
g 

Q_ 



226 




00 

o 
o 

CUD 

0) 
■*•* 

flj 
(J 

u 
!S 

V) 

O 

- c 

OX) 

< .2 

00 Q 
<U fc- 

= .a 



E 

> 

~?5 
-(— > 

Si. 
<u 
-XL 



3 

u 
1/1 



o 5 

i/i i/i 
i— i/i 

o > 

on • — 



38U» 



sruaujnH 



J3MOT jaq;o 



o 
en 
Q 



pup ;u3LU3puqdO 
puno/\A 





uoijpjndiuv g 



jnoiaj pup 



diH JaqiO 



juior joIpw 



00 

< 



8 

fN 

o 

Q 



Q 

T3 
C 

0) 



u 

c 
c 

o 
u 




fN 

Q 



fN 

a 
at 
O 



X! 
rrj C 

i/i 



227 





228 



■4-* 

o 

u 



- o 

C" 

8? 



«J ■ 
<x 

■.. o 

' -C:- ■■«'■' 



Abugngi|gyv pug 



av 

m 

rsi 

a 

a. 



m 



si;!|9Aluo3)SO 



q§im pus siAiad 
'dm jo uo!ieoo|S!a 



.• **'* 



m 



pup uiBJ^s 'uipjcJs 



siA|9d pue 



O 

a. 



r* ■ 



tr>- 



oo 
o 



00 
0) 



o 

CUD 
u 

o 
c 

00 



l/l 



o 

1/1 



— 1 u 

■o <u 

c c 

<n c 

^ o 



00 



bsouSeia JS^O 62 



§9-] J9MO"I 

)ue luivjaddn 

JO UOi;g3Q|SIQ 

pue u)Bj;s 



jooj pue 
j puEH 'tOIE3JOJ 
JO UOIlV0O|Sia 

pue ujE-as 



^81 



smsjng 
pue sijisoAw 



'siiiuopusi 





Au,iedoju,W: 
3i|padsuON 



Ampdojmjv 

Dl^pads pue 

9SB9SIQ 3UOQ 



>peg leoipaw g 





fN 
O 

Q 

O 
T 

fN 

o 

Q 



230 




419-177 O - 



84 -- 



16 



231 




« 



232 




P!OjXqj_ 













09 

cm 


' 1 


juauiapuqaQ 


i 











AjEimjy pup |BU3jpv ; -p£ 




CO 

0) 
v/» 

Q 

u 

"5 
JD 

<TJ 

• • *j 
O <D 

!? 

O C 
GO 03 
4> 



O 

uoi}B}ndiuv '.9$ 



T3 
C 

, .2 
._ -^j 

O 3 
c z 

S3 5 

3 ~" 



o 
Q 



< c c 



c 

o 

-E 

00 



n3 en 



233 




o 

psjojjg ujoqui . % ^ 




234 




rn 



O 
or 
O 



m 
O 



in 
o 
m 

O 
a: 

a 
S 

m 

O 
oe 
a 



235 




236 




237 




fN 

o 



in 




03 W> 
fN .2 
«" Q 

5c 'Jo" 



J E 

>■*- +-> 

o £ 

£ en 

T3 > 

S * 

■o 2 

C Q- 

rQ 0) 

0) (U 

u-> — 



c 
c 
o 

'€ 

CL 



2 



sssouSbiq jaqiO 



Eft 

a- 

a: 




UOdBOIUJEIjUl 



a::, o 




238 



bmpsDOJd yO^MlO 



)ui'|dai| pue 



a 




uo^pziucq 
• j pue a 



Adcosopu^ pus 
AdoDsojedcn 



gA|n/\ pUB 



^xaupv pub snjsm 





Q 

a. 



a 



pup |Enj;su3w 







VO 




f» 




a 








.a... <i 




CO** • 




>-0 : 








a 




CC 




a 


• to 




• p — 




co 




. O 




C' c 




V CD 











Q 




So 




m 




O 




a. 




D 



o 

Q 



O 
Q 



O 



en 
Q 



Cl 

E 
o 

u 

o 

T3 



■O 

O 

E 
o 

u 
II 

u 
u 



240 




in 
o 

00 

"S3 
u 



c 
g 

T3 
C 

o 
u 

i "8 

1/1 Q_ 

<u _ 

o c 
<u c 

54 



sssouSbiq 



m 

Q 
fit 
O 



? 3o 



LOI31 ||n j 




CO 

m 

AjurnELuaii 3LuaJixj a: 



S o c ± 



in 

o 
c 

W3 

vo.2 

r- Q 

iZ < 



"2 W3 

§ .E 

E E 

o cuo 

<: o 



-o 

T3 
C 



O 
at 
Q 

> 
o 

B3 



241 




1/1 

c 

WD 



WD 

c 

I 

o 



u 

u 
'■C 

o 
c 

vo .2 
- Q 

rXS) ^ 



o 
o 

CQ 

■o 
c 

"O 

o 
.2 

ca £ 

fc= 

v. o 
O 



o 



-a 
c 

1/1 
<D 



c 

'c 
g 

'oa ^ 

o Q- 

O 113 
c - 

3 oj 



T3 

c 



-a 
c 

03 



242 




243 




Q 





0\ 




r- 








O 








0) 
■*-> 








u 




u 








o 




c 












Q 


<v 




3 





<u 
"2 
o 



c 



00 



2§f 



c 

'c 
g 

on 2 

1/1 "3 

03 £ 
- I 

O I 

c- 

rcj <« 



uapjosiQ pooi)pi!q3g 



ex 

Or 
Q 



S 



O 

TO 

o; 



sasoqoXsd ^ 



uongpjpia* iPiua>A> p. 



or 
Q 



iojiuo-^ asindmi due £ 



.a SI 
a c 

C . 3 

.2 Z 
______ 1 Q.. .«*.... at 

-= o > 
sasojnsN £. sr 

.£ S. 
°- Q 



uoipunjsXa ipposoLjDAsd 
:o S33ugqjnisin pup 



uoipeay juswjsnfpv a^noy 



m 

a 
a 




246 



2* 
o. 
oa: 

U 

a 

3E-. 



o 

c • 



c 

CL 



O 

-«-» 
u 



>, .« 

o 
I— 



o 
u 



-a 
c 

its 



^ .2 

«N Q 
iZ ^ 



c 
c 

o 

CL 



c 

'c 
o 

'■£ 

Q- 



■a' 
c 




O 

in 

T 

O 
Q 

a 

at 
Q 



a 

a: 
Q 

■<r 

O 
a: 
Q 



247 



419-177 - 84 -- 



17 




248 




249 



Appendix IV: Reference lists for 
Schemes A, B, and C 



c 
01 
at 

C H- 
O 

••h c 
P rn 

flj rH 

u u 

•rH rH 
i— 1 tfl 

Q- rr> 
en x: 
tr q. 



E 
at 

P 
lit 
ZP 

cn 

3> 
t- 

D 
-P 
T) 
P 

•H 

Cl 

in 
a* 

cr 

Oi 

x: 
-p 

4- 
O 

in 
P 
ai 

P 
o 
m 



x> 
C 

nj 

in 

01 

in 
U 
o» 
in 



O 

cj 
Q 

z 





E 




e 
















ai 




ai 
















-p 




p 
















in 




in 
















zr- 




ot 
















10 




U") 
















n 




__r> 
















P 




P 
















o 




o 
















•P 




p> 








u 








T3 




ro 
















P 




P 








o 








•r-l 




H 






u 








111 


Ok 




CL 








p 






cu 


in 




in 






u 


o 




u 


P 


at 




at 














-J 


rr 




rr 






o 


-J 




u 


X) 












\ 


c 






ai 


CO 




at 






3 


Id 


u 


P 


u 


-C 




x: 












o 


O 


p 




-p 




<t in 


LD 


u 


\ 


p 








u 




rH 


iH 




"O 


CL 


c 




C 




i 


il 


II 


o 


C 




o 




o 


u 


o 






\ 


D 


E 




u 












3 




o 


in 




in 


f- 


cu 


CL) 


CU 




O 


o 


u 


u. 


&i 


o 


OT 


cn 


a. 


O 


1^ 


tr 


P 




P 


\ 


TJ 


U 


IQ 




II 




3 


o 


D 












A 


cn xi 




XI 


c 


m 




>D 






C 


at 


3 


01 


m 


£ 


E 


E 




ai 


rH 


u 




u 




x: 




X 


cn 


ai 


-P 


o 


-p 


o 


-p 


-p 


-P 


P 


m 


"J 


ro 


IE- 


in 


p 


UN 


in 




in 






P 


EL 


Cu 


CL 


Oj 


<C 


<L 


<[ 


nj 


TJ 


cu 




-C 




x: 








i-t 


•rH 


CL 


E 


CJ 


E 


CJ 


X) 


-o 


-a 


c 


c 


O 


o 








c 


C 


r- 


o 


Q 




□ 


P 


o 


P 


IB 


ro 


ig 


E 


E 


P 


':: 


o 


CL- 


o 








D 


o 


m 








~ i 


in 


in 


in 


Cu 


01 


a< 




<6 


OT 


IB 


■rH 




rH 


C 


c 


X 


c z 


r~ 


— 


P- 


P 


■P 






CJ 


■H 








•i-l 


■rH 


•rH 








p 


p> 


-P 


P 


x: 


x: 


JZ 


a> 


ai 


P 


m 


CL 


•B 


CL 


u 


u 


u 


r— 1 


i— < 


o 


p 


Cu 


P 


01 


c 


C 


C 


CL 


Cl 


-J 




u 


Qj 




o 


o 


o 


c 

w 




nj 


CL 


i< 


CL 




p 




p 




■iH 


21 


□ 


LU 


o 


LU 


G3 


(9 




cn 


CQ 


CL 


CL 




Q_ 




Z 


Z 


z 


z 


Z 














<T 








o 


O 




o 




o 


o 


o 


o 


o 


<j 


u 




cj 




o 


cj 


cj 


CJ 


CJ 


Q 


Q 




Q 




a 


Q 


Q 


Q 


Q 


Z 


Z 




z 




z 


Z 


Z 


Z 


Z 


<t 






< 




«t 




<C 


<£ 


< 


T-| 


ni 




n 




*t 


in 


•0 




CD 


o 






o 




o 


o 


a> 


O 


O 


tr 


EC 




rr 




tr 


cr 


tr 


cc 


cc 


Q D 




Q 




Q 


Q 


a 


Q Q 



p 
o 
-p 
"J 
P 



u 

iJ P 
O 

u 

a 

o iz 
^ H) 
3 

O 

r>. 

N II 

V A 

ai a* 
cn cn 

01 01 

in 

E E 

o 

•p p> 

CL CL 

E E 

cn in 
c c 

01 01 



u 



JUL 

. Cl 
u u \ 

XI 

P o c 



01 
E 
cu 

XI 

u UJ 
u 



3' 
P 

u p fO 

o c 

U \ O 

x> E 

o c 

3 a. 
O 

OM3 
N II C 
V A 01 



E 
ai 

XI 

LU 

m 
P 
01 

c 
o 
E 
<— i 
D 
CL 

XI 
C 
nj 



3 

xi O 

o C O N 

01 N II 

3 V A 
O 

O N at ai 

N II cn cn 

V A Ot 01 

a* oj in in 

cn cn at at 

ro 01 tn m 

o o 

ai a* c c 
in in cn cn 

nj nj 0J nj 

. 01 01 -rH >rH 

u in in Q Q 





in in ui 












u 




Q 




a> 




^ C C 


Ul 


QJ 


C 




C 








p 


p 


u 


rH cn cn 


CT, 


Di 


3 


u 


O 


P 


or, 


cr, 


o 


o 




O H H 


D 


W 


i-l 




•rt 


o 


C 


C 


p 


+> 


u 


xi in cn 






in 


u 


Ui 




D 


D 


>n 


01 




E 




X 


D 




D 


-o 


-J 


_l 


P 


P 


p 


Lu 3> =P 


no 


01 


CP 


O 


tP 


c 








■rH 


o 


p p 


p 


P 


tp 


\ 


tp 


>D 


f—i 


r-H 


CL 


Cl 


\ 


moo 





o 


LU 


3 LU 




fO 


ro 


in 


in 


XJ 


E P -P -p 


X 


_c 








O 


•rH 


-rH 




ai 


C 


in ro nj nj 


p 


-p 




O 


r-H 


r*- 




■P 


rr 


cr 


nj 


01 C P P 


o 


o 


ro 




01 


!! 




in 








i — 1 O 'H H 


E 


G 


f- 


u 


(- 


<"• 


P- 


P 


^ 


p 


Q 


CL E CL CL 


D 








D 




0t 


Oj 


Ot 


ai 


C_ 


O r-l m III 


at 


01 


QJ 


0i 


03 


Oi 




P 


X 


_c 


o 


cu d ai at 


c 


c 


i—'. 


CTl r-H 


CTi 


C 


C 


p 


+> 


o 


zacccr 




a. 


D_ 


ro 


a. 


fli 


!— 1 


t— i 


O 


O 


z 


z z z z 


z 


z 


Z 




z 




z 


z 


Z 


z 




■g- -3- T 


«hT 














-i- 




«t 


o 


O O O O O O 


o 




o 




o 


o 


o 


o 


CJ 


UUCJU 


U 


U 


O 




CJ 




u 


o 


a 


u 


Q 


Q Q Q Q 


Q 


Q 


Q 




G 




Q 


Q 


Q 


Q 


z 


z z z z 


z z 


Z 




Z 




Z 


z 


Z 


z 


<t 


< < < -c 


<c 


<r 


<C 




<t 




< 


<t 


<r 


<c 


i-H 


ru n ^ in 


<s 




CD 




o 




C 




rj 


n 


















r.j 




fd 


rj 


o 




o 


o 


e 




o 




G> 


o 


o 


o 


fx 


a: ct a: rr 


cr 








tr 




cr 


cr 


rr 


tr 


Q 


a q q a a 


Q 


Q 




Q 




Q 


Q 


Q 


Q 



252 



REPLICATION 
PHYSICIAN TEAM A 
FIGURE 

MAJOR DIAGNOSTIC CATEGORY 04 1 
DISEASES AND DISORDERS OF THE 
RESPIRATORY SYSTEM 

SURGICAL PARTITIONING 




253 




254 



E 
V 
+J 

ui 
>> 

CO 

>~ 
s. 
o 

« X*- z xz x «-> zx kh r t 

W O'^l a£X Kf-yX^KQXi-iJ Z £^axOiAJ<2 o<z 

OJ ZZSX3^iU<Z3 3i/ll stfx XH> 2 0<Z 3 uiyJXj^X X*-oiX^X Xh 

Q jhj<i3 j aja.uu *~ jj/)s^a><avi a^x xi-jxjj j«u,ij<;j'<3^iJ23>«j^ 

£ *- U« O 3*-y> 3JO>-2<3 3 XI IZ3X3 jj 3 3 JJ'/> 3 3 4J 

^tl JJZ^*-»- Z^ZXD)- 3X J 3*-.X3 Q JJS\ JJJ-1IZ3 J 3»-23 3 3— 
— <J^y)X3Z< JJ^X) JJZX'-f- «iJX 3 J«i3<-J— 3ZZJt'->- 3.£Xj£*-»- O 
«? „Z32 3<-<3-^l | x-« I ->>—S) <O-Jw0Za..uS: 3ZK2JZ3I i <JJ/)Z! I <J_i-OX-U 

5 o • I 32iJlJtay)^.uZ^Z3""3X«3-*-1 <Jj^)Zl I -u I I I I JJX-3-f ^trtK«3-*-l 
•r- — I I I I I I I— i i •/12JZJZ323X- 3-«-XX I XXKXjJjjZJIOJOjjZ JZ3^1 

+J «-«v/) nm<S)vl n-n n nisi*nJ°>~r>S>*X | I l l I I 3ZjjZJZ3<<><<<< 4ZZ I I I I I2ZI I • I IZ 
O 0.»33333333033J33^f»-'-t-t-'- I I I I I I » OCOC JCOCOC JCJC JJOJ J uO./lk/l.nyi3 
_ T" 4<ZZZZZZZXXXXXZZUUUJJUU«««<333333322ujjJuJiiJiJSa33333l 

£ £ ZZ^ZZZZ-<-<-<-"'-"— <->-■*-•— 2^22Z2Z^i-i-^i- 

•O 0> 2233333'J3XU.U.a.U.a.liZXXXZZX33333333333333>->'S9a3S»-SSSaS^ 

© _ JJiUS09!SXX'00O4(J^ZZZ^Z^^JJ3J333JJ33333« ««S 3 

4? "5 ZZ ZZZZZZZ3Q33a33iiJiJUJJJJJJ:iJJJjJJajj , XZZZZZZZZZZZZZZiJ 
Q -X- 33XXXXXXX33333J3XXXXXXXXZZZZZZZZZZXZZ33J33333333333J 

<— jjj'jjuujjjjjjjjjsssiosajsaa.Q.a.iiaaa.aaa.u.a.axxxzxxxxzcxxxxa. 
-a o> jjjjjjjjjjjjjj 

-- -f-f-^-t-t-,-^— r-f-f- «_ ,__,«. ^. nix a. iaa. a. a. a. a. a. a.ao.'- 



c c 



C 

0> o 



J2 



C 



un 

Q <- 3330333333393000333093333333303333330030333030 J33033 



s- 

u 

q] ZX X»— x XXXN Z2XXXI- Z ZX Xh- < Xf I2XX 

o z^axa^j<za33^j<^aaa^ *x x»- £^3x3^ £20x0^0x^03 

VI U<2 3 -UUJX^ -U4JXZ -U SZOX3»nJ<Z 3 JJ 3 aJaJXZ 

3>» UJX3 3 3KQ.jJZ3^3^Q.iJ33HjK«;« 3 OJJJX33 3>-jJ<<Z3 1 -U3 -J*- 

._ >— IT < Q» U V> 32C-J*- TC— JH— .UX 3 ~&y—*- l'J3TC«-»- (/> (X __l 

<3 —^>wO ZJj^ZZJ J3^XZ3ZJ3^lXOJ«^t- ZJJ^Z'^ JJi^IZ3IJ3 

g> Z'^Z3X-3-"'3ZI«J-f-JZ<-«U-«'-^ <JJ^ZZ3^-<3-»-Z3Z-<3-'hoz<-j 

^^iD3'iJ3ZjJJ.JXJI KZIZJI I XZ I X JZ'JXm J^JZ U£ JXJJZ4£JXJ I I XL I 
c O*- X'-J I I I I I I I >->-X I >■ 1 I OO'-U IOII 3Z'1IZ'JZ3 1 I I I I I I I i X I I I I ■>->- ±i I >- 
O >—JJ ji/i^h><^k><xi/ivijji/wwIi/Iiij4J I J^JUJ I I I I I I I XXXJCI fXZXnJXXiX'-'- 1 •••* 

ZX^-JJOJ iJ JJ JJ J JJ JJ.JJ-"— • I — "•^-^-^^L^JJJ^lJJJJ^-'»>^)'-0>"UT/1r-— 1— r-r— — ^-»». 4 1 
*^ -^JJ^-i JJ JJ-JJ_JtX"£ £t"S'3£ -U<C Z2JJJJ333JJJJJJJJJJJJJJ»->> 

;j<-ui x-i.a.a.a.;xa.33333JJa-a^ a 2 2zzzz2— •■<-« , *-»-j:3jjj3<<-«« 
t. x £i J£2.cxzzzjuijij iJijur— ai-ua u.xu.u.u.u.^ j ^o jaoa J j> j j 

0> u^42333333QJJJJJJJ t»>- ft- OaaaaUflZZZZZZZJ333333 < 

"O Z 3J3JUJJJJJia.ll^LlJJ»- J r-i— ^ i— , ->-<Z2222 Z222JZ2 

° £ < 3.-^-1 _J 33 J3JJ 

^ jc— 1 xi 33'oa3'aBfliia.aoaai:z23CT£X2>^»^»JJJOJjjJ jjjjjjjjjjo 

2: .c"- >ZJ-'—'-t-f-'— r-i— — iaXiiXXf)CXXXXXZZZZZZZZZZZZZZZZZZZ 
<-> on ZJC3-" *<<<< <<333333"3333333333333 
1 1- j^oJ£jX£St:X££Z):rZ£Z£2:XZ£XXZ££XXX£l IJJJJJJJJJJJJJJJJJJ 

o c3— a<i:ji3C"CXXTC'aejc 1: jc * ae jc fcacjc-jcjocaCTC icxxxzxaaaaa oaaxia-oxj-ofl oaaaa 
<_> u j-u/xnaiiai laiiiiiim 1ma.1a.1ni1— f-t— 1 — t-i 



OONNTOOOOOOOH^HHHHrt ooaaffl 0a7'J>l?7 1 J>3 > 5*O3OaOOO-<-<-«^-<^'>JNN'N'>J 
*J 4)N^H-n^O030QO03O3300O33OOO'J3333O333-<-<^HH-«HH-(H-<-.H-<HH-4HH 

^ 3330 OOOO OOOOOOOO OO 30 300 OO 30000 OOOOOOO 3 OOOO OOOOO 

c 

4/1 

0*1 



256 



Table A (Continued) 



Code 

01201 

01202 

01203 

01204 

0120b 

0120b 

01210 

01211 

01212 

01213 

01214 

0121b 

0121b 

01220 

01221 

01222 

01223 

01224 

0122!) 

01226 

01260 

0l2bl 

01262 

012B3 

012B4 

Olib5 

012bb 

0*03 

0204 

0203 

0212 

0*21 

0310 

0330 

0331 

033B 

0339 

0391 

0521 

0551 

0730 

0741 

09d1 

1 124 

1 140 

1 1505 

11515 

1 1595 

1212 

1221 

1304 

135 

1 363 

1370 



Tb 
lb 
fb 



English Description Code 

lb PLEUR1SY-NL t X AM lo20 

Tb PLtUKlSY-tXAM UNKN lb22 

lb PLEUklSY-MlCKL OX lt>23 

lb PLEUKl Sl-^LLT OX lb24 

lb PLtUk ISY-hl SICLUG UX lo23 

lb Pl_EUklSY-Llh TEST lb2b 

lb THlkaCK NLCE S-UNaPEC lo29 

lb 1HLKAX NUuE-NC EXAM lo30 

lb THUkAX NUOE-EXAM UNKN lo3i 

lb 1HLKA A NLLE-MlCkO OX lb3b 

THokAX NOOt-CLLT OX 163* 

1HLRAX NUlE-HlalU OX lb42 

lHLkAX Nuuc-OIH TEST lb4* 

IbOL TkACMtAL 1B-UNSPEC 164d 

iSUL I k ACHE A L IB-NU EXAM 1649 

IbUL IkACH Td-EXAM UNKN lbbcl 

1S0LA1 IkACM Tti-MICRU OX lb59 

1S0L IkACHEaL Tb-CULT DX 1951 

ISOLAI TkACH Te-H1ST0 OX 1*70 

laOLAl TkACH It-LTH TEST 19/1 

KESP Tb NEC-GNiPEC 1972 

kESP lb NEC-NL EXAM 1*73 

ktSF lb NEC-cXAM UNKN 2122 

KtSP lb NEC-N1CRC OX 2123 

lb NEC-CELT OX 2124 

lb NEC-HUTL OX 2125 

lb NEC-LTF TEST 212b 

PRlMAkY PNECMLM C PE AGUE 2129 

StCuNUARY PhcLCUK PLAGUE 2133 

PNcLMGNl C PLaGLE NOS 2142 

PULMONARY TULAfctPiA H\\ 

PULMONARY AKTEHAX 2312 

FULMUNAkY MYtCBAC TEH I A 2:>ld 

bbkOE TELL A FcklUSSIS <:3l9 

bbkucTELLA PAkAPERTUSSIS 235/ 

HHUUPING COCbP NEC 235b 

mHULPING LLiOoH NOS 2359 

PuLMONAk Y ACTINOMYCOSIS 2391 

VAk ICeLL A PNcLPOMTIS 3061 

PUSTMEASLES PNEUMONIA 4151 

LkNITHUSIS PNELMLK1 A 46410 

tPlbEMIC PLcLkCO YNlA 46411 

SYPHILIS OF LLNG 4obO 

LANLlLiAolS LF LONG 4661 

PklkAkr CUCC101UIUCMYCUS 4600 

HI3TUPLASM CAPS PNEUMGN 4b01 

H1S1UPLASM Obb PKE0MUN1 A 4b02 

H 1 S 1UPL A SMLS 1 S PNEUMONIA 4bOd 

PAkAGLN 1M 1 A S 1 S 4b09 

fcCH lNbCUCC GKAKUL LUNG 4bl 

IUXUPLASMA PhtlMUNlTIS 4020 

SAkCOlUGbla 4021 

PNtUMLCYSlLS 1 S 4b2* 

LATE fcFFECI fb, kESP/NOS 4b23 



kESP 
kESP 
kESP 



English Description 
MALIGNANT KEU TkACHt A 
MAL1G NEU MAIN bkUNCHUS 
MAL NEU UPPtk LUbE LONG 
MAL NEQ M100LE LUbE LUNG 
MAL NEU LGkER LUBE LONG 
MAL NEC BRUNCH/LUNG NEC 
MAL NEC BRUNCH/LUNG NUS 
MAL NEti PARIETAL PLEURA 
MAL NEU VISCEkAL PLELRA 
MAL 1G NfcUPL PLEUkA NEC 
MAL lo NEUPL PLEUkA NUS 
MAL Ntl AN 1 MEO 1 AST 1 NUN 
MAL NEC PGsT McUlAST 1NUM 
MAL NEU MEDIASTINUM NEC 
MAL NEU MEDIASTINUM NUS 
MAL NEU THLkAX/kESP NEC 
MAL NEU kESP SYSTEM NUS 
MALIGN FEUPL THUkAX 
SECONDARY MAL 1G NEU LUNG 
SEC MAL NEU MEDIASTINUM 
SECCNO FAL1G NEU PLELRA 
SEC MAL 1G NEU kESP NEC 
BENIGN NEU TkACHE A 
BENIGN NEU bkUNCHUS/ LUNG 
BENIGN NEOPLASM PLEUkA 
BENIGN NEU MEDIASTINUM 
BENIGN NEU RESP SYS NEC 
BENIGN NEU kESP SYS NUS 
BEN NEC klBS/STEkN/CLAV 
L1PLMA INTkATHUkACIC 
CA N SITU TRACHEA 
CA IN SITU bkUNCHUS/ LUNG 
CA IN SITU RESP SYa NEC 
CA IN SITU RESP SYS NUS 
UNC BEHAV NEU LUNG 
UNC BEHJV NEU PLEURA 
LNC BEHAV NEU kESP NEC 
KESFlkATUkY NEOPLASM NUS 
PSYCHUGtMC kESPlk 01S 
PLLMUN EMbGLlSM/lNFARCT 
AC TkACFElTIS NU UbSTRUC 
AC TRACHEITIS W UBSTRUCT 
ACL IE BRUNCH 1 T 1 S 
ACL TE BHUNCHlUL IT IS 
ALENUV1RAL PNEUMONIA 
RESP SYNCYT VIRAL PNEUM 
PAR 1NFLLENZA VIRAL PNEUM 
VIRAL PNEUMONIA NEC 
VIRAL PNEUMUNI A NUS 
PNEUMQCCCCAL PNEUMONIA 
K. FNECPOM AE PNEUMUM A 
PSELDUMLNAL PNEUMONIA 
H • INFLUkNZ AE PNEUMONIA 
STkEPTLCLCCAL PNEUMUMA 



257 



Table A (Continued) 



4o29 

4841 

4d43 

4d<*5 

48sb 

4817 

48«*8 

485 

4tio 

4870 

490 

H910 

4911 

4912 

1*18 

4S19 

4920 

4928 

493QC 

49301 

49310 

49311 

49390 

49391 

194 

4950 

4951 

4952 

4953 

4954 

49d5 

4956 

4957 

4958 

4959 

49b 

5C0 

501 

502 

503 

504 

505 

5060 

5C61 

5062 

50to 

5061 

5069 

5C7C 

5071 

5078 



English Description 
SI APHtLUCULCAL PNEUMONIA 
ttAtlcRlAL PNtLrUMA NtC 
bACltkUL PNcLfUMA NUS 
PNtUMoMA: LRGAN1SM NtC 
Put LM H CYlLFtG 1NCL U1S 
PNt LMUN 1 A IN hhOLP COUGH 
PNtOMLNlA IN ANTHRAX 
PNtLM IN ASPtRllLLUSIS 
PNtCM IN UTH SYS HYCUStS 
PNt LM IN iNFtt I U1S NtC 
dRONCLPNtUHUMA LRG NJS 
PNtOMUNi A , lkGANISM NUS 
INF LLtNZA hi 1H PNtLMUNl A 
bRUNChlTIS NbS 
o IMhLfc CHK bkLNChlTIS 
MUCLPLKUL CHK fcRLNCHITIS 
UttSTKUCT LHk cfiUraHlUS 
CHKLN1C dKuNCF.1T IS NtC 
CHRONIC bKLNtF 1HS NOS 
tHPHYStMAlLGS fiLtb 
EMPHYSEMA NtC 
laT aSIHHA H/L S1AT 
h S1A1US 
h/L SIAT 
h S1A1US 
STATUS ASTHM 
ASTHHAT 



ASTri 
ASTH 
AS1H 
AS1H 



tXT ASIHHA 
INT ASIHHA 
INT ASTHMA 
AiThHA H/U 
AjTHHA h STARS 
bkUNCHltCTASIS 
F ARMt R b ' LUNb 
bAGASSOSlS 
blRU-FANCltR j • LLNG 
SUBEROSIS 

MALI MuKKbKS' LUNG 
HUSHRUUM WuRKtRS • LUNG 
MAPL bARK-STk 1FPRS * LUNG 
"VENT 1L AT 1UN M FNEUHUN1T 
ALLkRG ALVtLL/FNtUH NtC 
ALLLKG ALVtLL/PNtUM NUS 
CHR AIRWAY UuSTRLCT NtC 
COAL HUkKcRS* FN t UHUCON 
AibtSTUSIS 

ilLICA PNtGPoCLN NEC 
iNUkG UUbl PNcLMCCGN NtC 
OUST PNtuMUNUFAThY NtC 
PNt liMLCUN 1 LS i S NCS 
FUM/VAPUk dKLM/PNEUMUN 
FUM/VAPUk AC FLLM tOtMA 
FUM/VAPUK UP ktSP 1NFLAM 
FUM/VAP AC KcSF CUNO NtC 
FUM/VAPUk Chk RESP CCNU 
FUM/VAPUk KtbF CLNU NUS 
FUUL/VUM1T PhtLMUNlTlS 
UlL/tbStNLt PNtUMUNlTIS 
SUL1U/L10 PNlLFQK 1 T NtC 



Code English Description 

•jo dO AC PUL FAN IF 0/T RAU 1 AT 

5081 CHK PUL MaMF U/I RAulAT 

5088 ktSP CGNO: tXT AGcNl NtC 

5089 KtSP CQNU: tXT AGtNT NUS 
5100 tMFHMA HUH FISTULA 
D109 t FPYtMA W/C FISTULA 

5110 PLEUklSY W/0 EFFUS UK Tb 

5111 bACT PLEUR/tFFUS NUT TB 

5118 PLtLRAL tFFUS NtC NUT Td 

5119 PLtLRAL EFFUS 1UN NUS 
P120 SPENT TENS PNEUMUTHUKAX 
512b SPGNT PhtUHUTHUKAX NtC 

5130 AbSCtSS LF LUNG 

5131 ABSCtSS LF Mtul AST INCH 
D14 PLLM CGNGtST/HYPGSI ASIS 
Dl5 PU S T INF L AH PULM FlbRCslS 
DlbO PLL ALVEOLAR PkUTt 1NUSIS 

5161 1C1L PULH HtMUSlOtKUSIS 

5162 PLLF ALVtULAR MICkULlTH 

5163 1D1L FieKUo ALVtULlT IS 
Dl6d ALVECL FNt LMONUPAT HY NEC 
5169 ALVEUL FNtLMUNUP A1HY NUS 
5171 RHELHAT1C PNEUMUN1 A 
517* SYST SCLtkOSIS LUNG 01S 
5178 LLNG 1NVULV IN UTH U1S 
51b0 PLLPUNARY CULLAPSE 

5181 INTERSTITIAL EMPHYSE FA 

Dlb2 CLMPtNiAILRY EMPHYSEMA 

5183 PLLPONARY tOa INOPH 1L I A 

518H ACUTE LLNG EDEMA NUS 

3185 PCS 1 TRJUM PULM 1NSUFFIC 

51dd LLNG DISEASE NtC 

5190 TRACHtCSTUFY CUMPL1L 

5191 TRACHEA/bkUNCHUS U1S NtC 

5192 HEC1AST 1N1T1S 

5193 MEDIASTINUM DISEASE NEC 

5194 DISORDERS LF DIAPHkAGM 
3198 kESP SYSTEM OlStASt NEC 
5199 RESP SYSTEM OlSEAbt NUS 
71481 RHELMAT C 1 D LUNO 

733b T 1ET2E • S OlSEASt 

7484 CCNGEMTAL CYSTIC LUNG 

7485 AGENtblS UF LUNG 
/HbbO LUNG ANCMALY NUS 
71861 CONGEN fckUNCH 1 1 C T AS 1 S 
74869 LLNG ANCMALY NtC 

7488 RE SF 1RATURY ANOMALY NtC 

7489 RESP1RATURY ANUMALY NUS 

75481 PEC1US EXCAVATUM 

75482 PECTUS CAR1NATUM 

7563 klB STEkNUM ANUMAL NEC 

7566 ANOMALIES LF DIAPHRAGM 

7dl5 CLLBB 1NG UF FlNGEkb „ 

78600 RE SP IRA 1UR Y ABNURM NUS 



258 



c 
o 



o 

O 



on 



C 



Z 'JJ Z —J 2 -J*— 'J o 

ouj tx i^za jo. o o oj a.</)< yj-nz 

ujci. <_j oujuj uQ3 a ijj 31 a. zojuj zao 

3 1 J3Z UJ33JJXK^aJ^Z Z3aJ^l JJZ I >» 
«JZ ZJ.j£Z I I jjZ-Uja.3ZalJX I <XZJJ< 

-<jj xxjjzxjjjajjujj a-uu<xuc-j jojoj 

Z>»-Z<<l ( »-(-JjJOa3 I I U"}3Z<uJ3*-Z.JZX 
3^3XXX<30IUI I 3 I >->- I Z I XII 0>x*-0 

zj3Z30«si^i z<^i z.Tcac>«"^">»-uzz« < 
^ac->;x:zxx:*zajuj3Z33Z333z acz <-«-*<ao>>ac 

•^•ZZ»-Q0II30 —»t- -"•»-ZZ~>~~> 3Kt->->aaMt>-UO 
3tyi«0«/Hi;f-»-Ej:>^oyi<« ~z JZJ 2U3Zh-KV)vi3^g 

OJX 333333X3X«3X — <— <30— OJS< Z~«-*<-> J 
U.O.'-OU.uJaJZX aJUJ3»~ OJ3^'UZZ X XZZ X> 03 X QC J- -J JS&J 

Q.aXXaaZJ<^3<«3X3Z3JU.ZZUK03^JS 
^X.-Z.^-Z «UJMUJQ£XIHI(-33 1 UOJ<w1J£Z UX 

zzj<u< *xuj ojlux oj 

«4«_>^JJJJ'^^J(J^au.ZXZZZZvUUJ^r-XZ DO 

<^t/)xxjexK«<«<z^zzz^4<o^a^-jiuj^xx ixaep-<zae 
j^Mu.au.u.axxxxxxjJJ3J3 MM xzx^xa.<Qjus3M4XJ«* 



I z 
£X 
3aJ 
Z*- 

OJ 

wo via 



ju 

JJ3 



Z-O-U 

>■ a 
xx 
a.-* 3 

ZXOJ 
Ui 

zza 



c 

o 



c 
o 







a. 


>■ z 






Z 


U33 3 




-J 


3 


JJ-J3-U-* 




OJ 


-J^l 


Zair-*-*- 




z 


V.3 


<j 






ZUOZ 


Q.U. «/)< 




z 


3^3 


Z _> OJ 










z 


3 




OZ3h- 






X.-^'N 


Jlt'J- 




u 


3Jt<Jp- 


*-«J I " 




< 


-*Z 1 


1 1 >- HM 


< 






MIX 


-J 


>• 




X JJ <JJ 






-T-TOJ _J >J 


uzzzz 




<3 


— ' JCaJ 




Zoj*- 


•/>«j jc_/i or -j 


u 


Z <3C 


^ < _i<-n < J >- z -jo.3 



3/>UJU3^3 Z Z 

33aja^aJGuj3 JJZZ JJZ 3aJ 

OJ-U./1_J33-0-J^aJ Za.aJjJZQ.aJ Jl 
m^3OJJ3U0^ZZiJ3Q.luJ3Q.Z'Ja 
OOJ I O J-J I JD'il'ilQ. I 331 I 3aJ I I 

jj-j-jo<"i i j«flujau^i i j^iazz 
_j • /> <o a ac -* « x) — « a a oc — » — ac */i z ac 

— '-J—- * JCi-^ IX_J'_J-*-* JC— )OJOJ 

X UX.JJ MM OJJCJJ u xj --n-n 

OJJJOC3»<> K/>aujxa>«<>x 

x x 3 1— 1— u» u. io «n s z 3 »- u_ a. z — • 3 3 
3 >»Z >*0C 




•^im-T* rg 3-^rg.-n*rv>Of^ oo^O^-siTl .nor* X)CJ> 



<_» r^f^(^r-r*^f»-f^f^f>-f^r*.f^f^.r^.r*r-r»3 0ox)0X)X)0ox)X)X)X)X)X)x»x)X)X)X)X)X) 



259 









o 










u 






zL 






|? 












LI 






p 


Q 






in 




CL 












c 






O 




g 


o 


s 


ti 


EE 


It 


*> 






in 


Ol 


« 


3T> 


c 


a 


01 




in 




*> 


n 


3> 


m 


6 


(■ 


s- 


IA 





0i 




*> 


a. 


a 


m 


□ 








(■ 






o 


a. 


in 


<*■ 


in 


Ol 




01 




in 


K 


cj 


O 






e 


01 


c 


a 











—J 


«- 




m 


o 




z 


in 






c 




E 


o 




f 






o 


■u 






■r-( 




CJ 


c 




a 


■tH 




z 


E 






01 






Q 




< 



E 

a 













cj 




»- 














CD 




CJ 




2 






LU 




»- 


in 










X 


e z 


< 


< 




CJ 








•< 


CJ > 


<L 




Q 


LU 




LU Q 


z 


< 






)"0 














E 


E 


CJ 






cn lu r 


-1 


E 








cn Q Q 


o 


M 


2 




LtJ 








< « 


LU 3 




X 


LU 






UZOI- 


E 




cn 






□ o z 




»-h 






_} 








a. en 


CJ 


;-- 


x 




z 






< 


i- cn 


LU 


E 




cn 




z z 


1- 


_l 










to 


-j 


LU LU 


<£ 


ra 


CL 


X 








r 


o u < 


E 






UJ 




»- 


X 


X 


(41 


CS 


g 






;= 


E -1 


_l 


»— i 


LU 


c 


z 




> 




Z LU z 




V) 


^< 






_l > E 




;~ 




< 








01 


> z 




LL 


cr 




o 






o 


« cr < 


X 


1 


UJ 




Q 


□ E Q 


X 


Ul 


■o 


E 


i- 




a. 


H* 


£ 






i- 


< 




E 


< 


LU N 




CS 




O 




E < < 




b 


X 


01 


□ 


UJ 


LL 


t- cs 


X 


X 


2 


< 


cr t- 




O > « 


_l K K 






_l 






t- z. « 


n 


u. 




a. 


< 








- < 


X 


X 


O 


cr 


D < 


> 




r o 


LU cr o 


o 


„i 


LU 


u 


< 


Z E Cc 


-z 




<s 


< 


»-i 




_l 


CJ 


£ CC CC 


€ 




LU 


u cr 


z =. 


□ E 


L0 < LU 


UJ 




cn 




E 


O < LU U K 






Q 


O 


X 




EC I 




K 


e 


E 


_J LU 


c 




h- < 


cn a cn cn > 


cn 


-: 


LU 


U £ Cl 




(j 


> 


Q 


UJ 




E 


u 


o a. 


a. 




X 


□ 


E E 




_J 


o o 


LU Z Lu 


LU 




LU 


X 


E 




1- z> 


01 






:- 


2 


« 


LL < 


< 


E 


E 




o o 


€ 


LU 


> U E 


E 


E 


> 


X 


□ 


LU 1- O 


o 


Q 


(- 


E 






HI 


K 


LU -i 




< < 


Z Ll 






i- t- 










:- 




O Z U 


D 






o 


»- 


cj 


-1 


Q 


a a 


a 






cs 


O cj Q 


a 


o cn 


u o cn 


cn 


> 


(J 




> 


< — in 


Q 


o 






CJ 




£L 


S 


cn uj 




Q 


e 


it 




E 


<z 


E LU 


HI >-! LU 


UJ 






LU 


E 


i cn 






•4 


> 


D 


H- 






LU 






E 


cr u 




€ 


< I 


U (J > 


> 




u 


Q 


y— 


E LU « 


O 


O 




cn 


CC 


!2 


E 




G cn 


E 


UJ 


CC 


X 


i-i < 


u 


U 


(J U 


< < 




< 


s 


D 


2 


e cn Q 


< 


< 


< 


a. 




X 


UJ 


cn 


»— i-i 


X 


cn 


Lu 


E 


< cr 








cr e cr 


E 


E 


E 


_l 


E 


□ — 


E 


E 


I 


o 


co 


u 


2 


□ 


cj cj 


:~ 


c 


X 




Cl o 


E 


E 


x z 


□ GO 


□ o 


c 


O 


1 


E J Q 


o 


□ 


a. 


t— < 


LlJ 


UJ 






LU X D 




h- 




U I 


UJ 


LU 


LU E 


XXX 


X 


I I 


u 


UJ 


LU X < 


X 


I 


u 


Q 


a 


a 


O 


u 


a. lu 


to 


o □ 


Q 


cr h 


E E CL O H K t- 




t- 


r- 


□ 


CC 


I LU E 


t- 





LU 
LU K 

cn <; 

O C5 
_J 

U _l 



cn z e 

o « 
z - «t 

O (— E 

LU Z < E 

Z E (J E 

LU m 

E X «J < 

o a. — 
X z 

I- E <J E 

CJ < i-i LU 

D ~ I- I 

Q Q < 

1 E 
O E O 

< 
E 
X 
E 
< 



m LU 

E 
< 

E E 

□ G 

1 I 



Z 
E 
E 
K 

cn 
< 

. E 

a e 












CO 


Z U 


C0 Z Z U Z 






t- 














CJ 




CJ 


E 


























in 






CO 




O LU 


LU O O 


UJ 


o 






CJ 














u 




LU 


E 




E 












CJ 




> 














X 


« z z 


1 i— 1 HI 


X 


1-4 




> 


X 


CS 






> 






X 




X 


X 


cn 


E 












E 




z 


H- 










X 


> 


K O 


CO (- 








X 


E 








cn 




u 










o 


X 












z 




c 




2 








> 


X 


< Mum 


o < 


in 


CJ 




Q 


K 


X 


cn 




E 




LU 


CJ 




CS 


X 


_j 


cn 


CJ 














f- 


CO 




c 






X 


t— 


E H LU O 


z u u 


LU 


Ll! 






tn 


-J 


X 




□ 




X 


X 




2 


CO 


cj 


□ 


E 










2 










LU 






t— 




□ cn < z x 


O x « 


_1 


cn 




U 






X 










E 




X 






X 


^- 












CJ 




> 












Ll 


JD K O 


E LU _l 




LU 


o 


LU 


o 




CJ 




D 


> 


CJ 


E 




_J 




< 


o 


















X 


< 


■o 






LL 


o 


e z cn z z 


a e 


o 


E 


X 


X 


X 


a 


X 


cs 




cn 


□ 








X 


X 




E 












Z 


q. 


c 




Ol 






□ 




x > Z) < o < 


_J 


X 






o 


E 




o 


2 


_l 


E 


E 


CJ 




E 


E 




z 












< 










*> 




cn 




X 


111 I £ J H J 


h 4 O J 


X 


J 


- 


□ 


X 


E 


X 


« 


X 


E 






□ 


E 




□ 




Lu 


z 


< 




E 


z 




b 


LJ 


IB 


> 


Z: 


X 


o 


t- > E K D 


U i-i UJ 


_l 


Z 




X 


X 


X 


a 


X 








(- 


> 




CJ 


cn 




E 


2 


< 


CS 




E 








X 




cn 


X 


□ 




Q I CD < (— 


3 X _J 




2' 


E 


X 


:- 








X 


s 


X 


CO 


1- 


in 


<£ 






X 




















> 


E 




:~j 


s 


_i e i- z e cn 


e cj a 


CJ 


_J O 


s 




Hi 


E 


E 


CJ 




e o 


cn 


E 


_i 


E 


< 


E 


E 






Ll 


5 




> 


E 


E 


Ol 


O 


> 


>XJ 




LU O <C LU « 


K Z 


a 






E 


CJ 




O O 


2 


cs 




z 


< 


<I 






E 






Lo 




LJ 




< 


E 




o 


(. 




X 




u 


i- E E E E 


cn o < 




_J > 




LU 


CJ 






□ 


z 


X 


cs 


_i 


X 


X 


J 


Lu 


i 


< 




I 




X 


E 










cs 


C 


u 


X 


E Z O t— O 


LU E Z 




c 


X 


LU 


cn 


X 


X 


z 


E 




< 




E 


_J 


<L 


<L 


CJ 


<r 


E 


< 


< 


UJ 


< 


E 


1— 




z 








>c 


LlJ 


□ < 


Q a LU 


> 




o »- in lu 


□ 


o 


DO 


X 






G 


c 






< 




E 


E 




E 




C 


< 




G 


< 


cn 


CJ 


LU 




cn "-i e cn cn lu 


in 


a 


2 




LU 














X 


Q 


CJ 


(J 


X 


x x 


X 


E 




T 








Z 








E 




_l 




_l E > 


E 


ll; 


U 


_l 


Q 


E 


cn 


cn 


E 


E 


CJ 




<£ 




CJ 


CJ 




E 






CJ 




y 




□ 


E 




< 


z 


X 




X 


z « < z r u 


< LU X 


t- 


X 


LU 


E 




LU 






UJ 


UJ 


2 


CS 


E 




2 


Z 


C 


Z 


CS 




2 


CJ 


^_ 


C 


_J 


E 




I 


> 


> 


e 


1- 


> e > > < 


(J X E 


cn 


CS 


a 


z 


C 


X 


o 


CJ 






C 


2 


C 


E 


X 


X 


z 


c 


2 


2 


G 




X 




E 




CJ 


E 


i 


X 


< 


□ 


X Z LU X I E 




LU 


LU 


O 


o 


X 


f- 


z 


z 


K 


P 


E 


X 


X 




E 


E 


X 


E 




X 


E 




E 




X. 


E 


z 


O 


t- 


!- 


E 


t- 


1- ►-" E H K K 


j o yj 


a 


cn 


J 


U 


E 


□ 






O 


□ 


ca 


X 


t- 


Ln 


ca 


ra 


_J 


ra 


Zj 


_i 


ra 


E 


ca 




E 


E 





01 


o 


o 




rj 




rii 


n 


«T 0- 


n 








t> 
















m 




DO 


o> 


«j- 


o 




ru 


n 


CD 


Cr 




ru 


n 


CD 


o 


C\> 


n 


•a 




CD 


CD 


CD 


o 


o 




o O 


N 


o 




ru 


Til 


n 




m 


-0 


o~ 


o 




r u 


ry 


rj 


rii 


n 


n 


— 


«t 






«t 


in 


o 


Ct- 


Cr 




o 


o — 


o 
















N N 




ru 


rj 


rj 






n 


ru 




fi! 


n 


n 


n 


n 


n 


n 




n 


n 


n 


n 


n 


n 




n 


rl 


n 


n 






CJ 


o 


o 


O 


o 


O 


o 


o 


O O 


h 


n 


n 


n 


n 


n 


n 


r, 


n 


n 


n 


R 


n 


R 


n 


n 


ri 


n 


n 


n 


n 


n 


n 


n 


n 


n 


n 


n 


n 


n r. 



260 



zr 




(_ 




O 




■p 




<b 




u 








a. 




in 




ft 




cr 




HI 












c 




o 




Ul 




01 




u 


cj 


z> 




■D 


(J 


01 




u 


•u 


o 


3 


(- 





0. 


JZ 




+> 


6 




o 3 







cr 


-p 




Ul 


Ol 


lb 


c 


-C 




u 


•+» 




IB 


t- 


u 


o 


ai 


—a 




IB 


□ 


z 






CL 


Q. 




01 


o 


U 




x 


O LU 


a 




z 


6 




(L 




*> 


< 


l/l 


cm 


3i 




in 


o 




cc 




Q 





c 














o 










































O. 




























u 














u 














01 














>i 














Q 




(J 












LU 


LU 




< 






IA 


Q 


Z 


(j 










O 




X 


z 




a: 




z 


u 


UJ 


IT 


o 


»— i 


Ol 


LU 


LU Z> 




LU 


UJ 


o 


c 


_l Q 


D CC 


LU 


I 


cr 


z 


LU 


< O 


O t- 


Q 




(- 






CJ Z 


z in 


O 


cr 


in 




■o 






z 


X 


LU 


LU 




> > 


-J X 




0- 


3 




*> 


cr cr 


< 0. 


X 


< 


o 


< 


q 


LU < 


z z 


a, 




LU 


U 




CJ J 


— > 




Q 


in 




> 




3 -1 


> 


1 






Ol 


CL <— 


C5 




cr 


LU 


tn 


f- 


LU x 


Z (J 








UJ 


-O 


LU < 


' X 




< 


< 


X 




Q 


LU 


< 


CL 


U 


o 




1 1 1 

LU 


1 1 1 

LU 




LU 








in w 


in 


a 


cr 


t— 


cr 


< 




—i a. 


t— i 




in 


UJ 


I 


u o 


o z 


o 


Q 


UJ 


X 


CL 


X X 


X l-H 


LU 


ca 


X 


t- 


u 


LU LU 


lu in 


or 


<c 


CJ 


□ 



X 










> 


> 


UJ 










UJ 




UJ 






O 


cj 




in 


1- 


z 


E 







X 


cr 


UJ 










UJ 


Z 


t— 


LU 


> 


LU 


u_ 





O 


< 


UJ 


< 






< 


LU 


< 




< 


o 


z 


in 


_i 





H- 




u 




cr 


< 


<c 





e 


CJ 


< 


_J 


UJ 




CL 




1 





cj 




< 





CL 







< 







CL 




> 


□ 


UJ 


LU 


UJ 


LU 


1— 


u 


X 


LU 




t— 





i- 




r 


rn 














UJ 




I™ 


cr 


t — 


in 




in 






O 






O 


O 


in 


in 


LU 


(- 


1 




m 


UJ 




UJ 


in 










S 


S3 


O 





X 


id 


UJ 


LU 


UJ 


1 


in 


X 


LU 


z 


o 


UJ 


LU 










O 


UJ 







X 





UJ 




X 


LU 


Q 


z 


z 


LU 




LU 


UJ 




X 


z 


<t 





1 


X 


1 


u 


_J 


UJ 


o 


o 


O 


UJ 







O 





X 


u 


1 


X 





Q 


1 


LU 


3 


Q 


Q 


< 


O 


< 


< 


1- 


1 







z 




1 


LU 


Cfj 










CJ 


< 


CJ 


CJ 




(- 






□ 


u. 


m 


O 


CL 


UJ 


LU 


LU 


UJ 




O 






t- 


3 


X 


in 








□ 


O 




o 


o 


o 








t- 


LL 


10 




UJ 




\~ 


in 


cr 






< 


<I 


< 


in 


1- 


in 


cn 


< 




O 




< 


z 


< 


CL 


LU 


1- 


cj 


cj 


o 


LU 


in 


LU 


LU 


cr 


t- 


Z 


u 


X 








Z 


CJ 








X 


UJ 


X 


X 





in 


_J 










X 


□ 


< 


1- 


H 


H 


cj 


X 


cj 


CJ 









cr 


Ul 


> 





Q 


a 





in 


in 


tn 




(J 






LU 




UJ 


UJ 







UJ 








UJ 


UJ 


LU 


CJ 




X 


»- 


2 


cr 




X 


h- 


z 


(- 


X 


X 




X 


X 


X 


X 


X 


t- 


O 


O 


LU 


a 




Z 


UJ 


in 


t- 


1- 


<. 




CJ 


u 


UJ 


UJ 


O 






0. 


G3 


O 


(— ( 


cr 


□ 


O 





cr 



01 


1 — m 


«r 


■0 


ru di 
















1 «j- 





n 









ru 


n 


■3" 







CD 


l> 


O 




n 






-0 




CD 


O 


r» 
Cii 





n 




N 




r» 










rs. 


CD 


CD 


CO 


CO 


CD 


CD 


cc 


CD 


CO 


fu 


«5- 


m 


l> 


N 






rs 








N 














rv 


N 


r» 


O 



h Description 
















> 




CJ 


in 












CC 




> 








in 




z 


> 




> 












LU 




IP 








in 


M O 








>• 






z 


> 


LU 


LU 


CJ 










LU 


> 


Z 


z 




Z 


Lu 


z 





a 




in 


U 


CJ 


in 


< 


cc 


2; 




Z 




> 




■pH 


— LU 








z 









E 


z 


_i 


<Z 


10 






CC 


U 


z 


O 


a 




O 


X 





t— ( 







CL 


LU 


LU 


LU 


CC 




<: 




O 




in 


u 


»— * 


_J z 











> 




V- 


O 






J 





z 






< 





K 


»— * 


cc 




Q 











G 


z 


Z 




3 


< 


z 


> 






g. 


z 


Ol 


<I 








K 


z 


> 


cn 




< 


X 




_i 







< 


-J 




in 


h- 




in 


< 


t- 


< 


in 












LU 


CL 


LU 


< 


1- 


CJ 


3 




c 


« in 








CJ 





z 





10 


aJ 


Z 


-I 


u 




cr 


CL 




in 





u 


< 


Hi 






cc 


□ 






X 


X 


_l 


J 


LU 


CJ 






u. 1 






LU 


CL LU 








LU 


t- 





LU 


□ 


X 


> 


< 




in 


1— 1 


UJ 


_J 





LU 


3 


CL 


> 


X 


cc 


LU 


CJ 






<: 


3 




CL 


a. 


< 




cr 


Z 








D _J 








O 


u 




I 


UJ 





cc 


UJ 


< 




< 


cc 


< 


LU 


X 


cc 


LU 




Z 


LU 


CL 


< 




J 


tr 


Z 


< 






CL 


< 


Li 






CL 


■0 


in 


> 


> 


> 


Z 


LU 


U 


u 


I 


< 


< 







> 


CL 




UJ 


I 







CC 


a 


> 


CL 


O 


cc 




<c 


O 




3 


Ll 


i 




Z 


Cl 


z 




c 


01 


0: x 


r 


z 


r 


> 


O 


LU 


< 


u 


CC 


_l 


z 


O 


LU 


UJ 


_J 


I 


CJ 


< 


cn 






CC 


□ 







> 


z 


X 


1- 




O 




< 


LU 


O 


c 


CJ 




*> 


< z 











cr 


Z 


O 


cr 


< 






> 


1- 


CC 


CC 


< 


CJ 


< 


CC 


z 


_1 


> 


< 




_J 


X 


CL 




tr 


tn 






< 














•D 


z > 


H 


1- 


h- 


< 


> 


Z 


H 


cr 




u 


CC 


tn 






LU 


< 


CC 


1- 





< 


cc 


_1 


_l 


< 


H 


O 






<z 


m 


Z 








> 






"C 




cr 


CJ 





O 




cr 


> 




K 


X 


3 


<c 


1— » 


> 


X 


O 


cr 


t- 




a 


LU 


LU 


•s. 


< 


UJ 




a 


in 


LU 






c 






Ll 


O 








> 


t- < 


LU 


LU 


LU 




< 


cr 


_J 




Z 


CC 


-1 


u. 


z 


Ll 


z 


1- 




LL 


LU 


I 


Z 


I 


LU 


I 


< 


in 


< 


cc 


a 


X 




t- 


< 




c 


a 


in 




01 


in _j 


O 


O 


O 




_) 


< 


< 


r 


> 


t- 











> 




LL 





cc 


CJ 




u 


O 


u 


CC 







3 


LU 


CJ 


1- 


in 






ca 


LU 






6- 


> 


Z 




cr 


cr 






z 


or 


CC 


in 


LL 


_J 


(- 


J 


CC 


LL 


O 






<C 


_l 


< 


z 


<r 


3 


z 


Q 


Q 


r 




< 


LU 


Q 


Z 




CL 


CJ 


CJ 


^2 


t- 


> 


1- 





<c 


UJ 






UJ 


<t 


LU 


O 


< 


in 


< 


<t 







z 


_J 


CC 


< 


cc 


> 


cc 


LU 




LU 


lu 




K 


CJ 






O 


cc 


□ 













K 


u 


CL 


H 


_J 




CL 


—1 


a 




UJ 





LU 


-I 




LU 





< 


H 


LU 


h- 


CC 


t- 


J 




z 


u 





(J 




CJ 






< 




r— 






x D 


< 


O 






UJ 


< 


in 








LU 







O 




LU 


CC 




LU 




CJ 




<t 




CL 


tn 










3 


LL 




Z 




_j 


_l 


< 


< 




Z cr 




_J 


-l 


cr 


J 




< 


cr 


in 




CC 


z 


z 


Z 


CC 


CC 


3 


in 


I 


CC 


z 


cn 


_J 


cc 


10 


<c 


cr 


cc 


cc 


cc 




cr 


4 


<c 




LU 


I 


X 


<z 


> K 




O 


< 


LU 


CL 




1—1 


LU 




< 




> 


> 


> 


LU 


D 


in 




CJ 


LU 


> 






LU 


z 




Lu 


CL 


0- 




CC 


y 




u 


CJ 


10 






X 


cr in 


r 




u 


X 


z 


Q 


Q 


X 


O 


CJ 




CC 


CC 


CC 


I 


t— 





> 


< 


~r 


cc 


tn 


T 


X 


< 


D 


X 






m 




X 


CL 








Z 




CL 


< LU 


LU 


CL 





t- 





< 


UJ 


t- 


z 





D 


<r 


< 


< 


h- 


D 


— 1 


UJ 


CC 


h- 


< 


> 


h- 


h- 


cc 


LU 


1- 


X 


X 


lU 


CJ 


K 




—J 




LU 


> 


> 





-1 O 


X 


LU 


> 


O 




cr 


z 


O 


»— 1 


J 


in 


—i 


-J 


_l 


O 


in 


CJ 


CC 







_l 







D 




z 


O 


D 


Q 


Q 


in 


O 




LL 


> 






«J 



01 




o~ 






CM 




















rj 


n 


<j- 


O 




CM 


•a- 


in 






To 


n 







fu 


4 














in 











O 


■0 










rj 


ru 


ru 


n 






OJ 


n 


in 








■0 














0- 


l> 


l> 


i> 




fu 


CM 


rj 


CJ 








00 




cc 










































































C 


<? 


T 


■s- 










CO 











c 


CJ 


n 


n 


m 


n 


n 


n 


n 


n 


n 


n 


n 


n 


n 


n 




rn 


n 


n 


n 


n 


n 


n 


n 


n 


n 


n 


n 


n 


n 


n 


n 




n 


n 


n 


n 


n 


n 







261 



in 
ai 
cr 

01 



C 

o 

in 
01 

f- 

3 

•o o 

01 

U U 

o 

t- -c 

D. *> 

E 3 

o 

-w 
£T in 

Ol 

01 -c 

c cj 
*> u 

ID O 

(- -» 
oi m 
o.z 
o 

■P 
. a. 
Q_ oi 
<S" u 
O x 

UJ 

u 

q e 
r oi 

4» 

. in 
< 

C9 

cr 

Q 



tn 

in c 
-I z 

z s 

CS Z _J 

< - 

tr >- u. 
I 01 o 

QL < 

< ~ Z 
- Q □ 
Q LU — 

z k 

Ll < 
Dl-U 
cj >~ 
> D t- 

n k tc 

CL t- O 

o tD cj 

« UJ UJ 
D9QQ 



U 

z^2 

o < 

« j a. 

tn ^ uj 

~ t- GT 

O ID 

X « > 

UJ Li. t— 



<t « 

c u 

Z < 

UJ tr 

_l o 

0. X 

tr 

uj cn 

I o 

t- _i 

□ o 



Z t- 

□ < 

« UJ 

cn o 
uj < 
-i —i 

z z 

a 

< < 
a: tr 

1 X 

a. a. 

< < 



< cj 
-i cr uj 
z « z 

tn o. z 
« uj o 
u. cr - 

K < 
IKE 

O C5 CT Z 

< < UJ UJ 
cr tr d. _j 
x x o a. 
a. a. 

< < 



z u. 

C5 O 

< 

tr tr 

tn uj a. < 

o x < a. 

J h w In 

cj a o cr 



Q Q - « 

o a 

UJ UJ 

tn tr 
«- Z 
cj t- 

uj tn 



< > 
cr z 
uj □ 
a. i- 
o o 

u a 

« cr 

cj < 

< cj 
cr « 
o cr 
X uj 
k a. 



> 
tn 
a. 

o > 
« z 
q a 

h- 
_l CJ 

< UJ 

Q Q 

cr cr 

< < 

u cj 

tr tr 
u u 
a. a. 



o 

■c cj 

tn uj 

tn z 
< 

Z o 
z 

-> _l 
Q UJ 

cr tn 
< tn 

cj UJ 
> 

tn u 
uj ~ 
X cj 
cj < 
cr 
z o 

CL X 
O h- 



> tn < 

z < _i 

o z a 

t- < ui 

cj \ cr 

UJ K 

tr u 3 
uj UJ 

k tn t- 

tr uj u 

< cr uj 

a to 

z _i uj 

uj uj cr 
tn 

<j tn tn 

« uj uj 

cj > > 



Z cj 

O uJ 

" z 

tn 

— tn 

u UJ 
x > Z 
UJ □ 

_l -I K 

UJ CJ < 

tn < tr 
tn cr uj 

Ui O CL 

> I o 



> 

ui cr 

o H 

Z Z 

-I UJ 

cj I 

u uj 

O tr 









UJ 










tn 


x cr 


Ul 


o 




o 


UJ 




<z - 


CP 


< 


! i ! 






*C 


o cr < 


« 


CJ 


o 


CJ 








LJ Li- 


CJ 










Q_ 




X UJ 








^ 






_j 


i- tr 




tn 




U J 


1= 




a 


i 


cn 


UJ 




1 1 i 

UJ 


tn 

U J 




cr 


UJ UJ 


UJ 


X 


to 


-r 

J— 


LL T 


r_ 


t- 


O C 


X 


CJ 


UJ 






UJ 


z 


Z <£ 




1 


z 


1 





_i 


o 


X U 


1 


X 


CJ 


Q 


1 


UI 


CJ 


(J 


Z 




1 


UJ 


U"j 






K 


o u. 


ID 


CJ 


CL 


UJ 


UJ 


x tn 








O 


Q 


> 


o 


1- LU 




K 


tn 


CE 






< 


o X 


< 


z 


< 


a. 


UJ 




X 


Z O 


X 








z 


u 


tr 


-J 






CJ 


X 


D 


< 


cr 


tr 


LL 


> 


a 


Q 


a 


□ 


□ 


aJ u 




G 


u 








z 


Z X 


(- 


Z 


(- 


z 


T" 


c 


UJ 


O t- 


z 


UJ 


tn 


K 


1— 


< 


X a o 




cr 


o 


C 


c 


or 



I>_^t>n«r«rdnvt>ni>njv — — inu^ininuiinirj^cti-- — « « « « — 
nnlnln^^(IlooacDCD(^l^-■rjn^■o-n'^lnJJcoln(^n'^ln<l^o3c^r^ 



01 
Q 



si 

c 

LU 



> 
01 

f. 



X 
a. 



tn 
tn d 

D Z 

Z > 

> X 

X H 



< 
tr 
o 
u. _i 
u. □ o. 
o x 
tn z uj 

> o z o 

UIZOhQ 

cl « cn _i 

o > cn i-h uj 

z cj —i 

a o u x u. 

h X LU 

tn cj uj tn 

D UJ _) D 

z z t- < z 

> > cr k > 
x i < a i 

K h 1 h K 



z 
o 



cn 
n 

z tn 

> D 

X z 

I- > 

X 

U. H- 

o 

U. 

z o 
o 

— ' cr 

cn — 

- < 

CJ CL 

z u 

— cr 



CJ 
UJ 

z 

cj cn 

LL O 

Z _J 

CJ 

z 

o < 

_J 

< H 

tr tn 

UJ >-i 
tL Ll 
□ 

< 

cn uj 

z x 

z o 

> < 

x cr 

t— i- 



tn z 

uj □ 

_i « 
tn 

o « 

Z cj 

o 

CE 
S 



Z cj 

Q UJ 

- z 

I- 

< cn 

CJ LU 



-i cr 

<t ui 

CJ X 

O t- 

_l O 



cl e> 
z 

ca Z 

UJ -I 
_J 

ca cj 
□ 

< _i 
z 

UJ > 

cn o 

> tr 

X H 

cl cn 

z UJ 

UJ Q 



(- 

CJ 

UJ 

cn 

Ul U 

tr z 

Z) 
C5 _J 
Z 

D U. 
_1 O 



cj 

> tr o 

Z I- z 

□ cn z 



t— cn 

UJ CJ 

u cn x 

i- cn uj 

UJ i— 

J Q CC 

CL LU 

Z Q X 

O < H 

u cr o 



cn 
z 

T 

o 

z o 

o z 

cr z 

ca _i 

u. u. 

o o 

z z 

o o 

cn cn 

CJ CJ 

z z 



> 
cn 

CL 

o 

« > 

CS CD 
CL 

_l Q 

< « 

•-• Cfi 

o 

z o 

o z 

cr z 

ca _t 

tr tr 

UJ Uj 

X I 

t- t— 

o o 



cj 

o 

tr cj 

CL "-i 

x cn 

Q O 

z 

_l o 

< < 

X Q 

cj 

Z C5 

o z 

tr z 

a _j 



o UJ 

uj tr 

z z 
t- 

o z 

z cn 
z 



Ll tr 

o u 

> CJ 

I- CD < 

CD CL _) 

< < 

_1 _l _J 

a. _i < 

c o - 

cj o X 

< cj 
cr o z 
□ cr o 
X z tr 
k CD ca 



<£ 
_J 
Z 
(- 
CD ~ 



UJ 

cr 
z 

tn cj 

□ LU 
-I Z 

CJ 

tr 
z - 
o < 



z 
□ 

N-l (J 

t— (— z 

z < z 

<. a -i 



i uj I 

< cj < 
« < « 
I 
u 
Z 
□ 
cr 
ca 



CJ 

o z 
Z o 
z tr 



_i u. 



< < LL 

cr — cr 

H Z Z 

CJ I- 

c z o 

z □ z 

z cr z 

J CS L 







> 


Uj 


z 






z 






z 




c 










r— 


CD 




z 




□ 






c 




CJ 


> 


Cfi 




LL 


< 


r 


< 




z 


a: 


□ 








c 


>— 




tr 


z 


z 


3 


ui 


Uj 




»— 


CJ 


z 


CL 










c 




>. 








< 




5 


s 


_i 






T" 




< 


LL 












< 




£ 








Z 




L,' 




□ 


LU 




*c 


o 


1 


C- 




U 


z 


CL 






cr 




X 


uu 


z 


a 


Uj 


UJ 


tr 





o 

CJ 



■oo-n-iwn<ft>n — o inf^cr;o«a-o v — rurriuo oj n cd o ru n 

«oofflfrt>t>(>t>NO«t\i , Mnv«4(hO'-rirjfi;riinne«f**»int>t>t>t>oo»< 
rvr^NNr^NNrvr^ — rjriirjriiriiriiriinrjnnnnnnnnnrjnnnnnnnn'f^T 
ooooooooonnnnnnnnnnnnrtn'n. nnnnnnnnnnnnnpinn 



262 



DRG 4A, MDC 04M. Bronchitis and Asthma. Age 0-14 



Principal Diagnosis 



Code CPHA Abbreviated English Description 



0330 BORDETELLA PERTUSSIS 

0331 BORDETELLA PARAPERTUSSIS 

0338 WHOOPING COUGH NEC 

0339 WHOOPING COUGH NOS 

46410 AC TRACHEITIS NO OBSTRUC 

46411 AC TRANEITIS W OBSTRUCT 

4660 ACUTE BRONCHITIS 

4661 ACUTE BORNCHIOLITIS 
490 BRONCHITIS NOS 

4910 SIMPLE CHR BRONCHITIS 

49300 EXT ASTHMA W/0 STAT ASTH 

49301 EXT ASTHMA W STATUS ASTH 

49310 INT ASTHMA W/0 STAT ASTH 

49311 INT ASTHMA W STATUS ASTH 

49390 ASTHMA W/0 STATUS ASTHM 

49391 ASTHMA W STATUS ASTHMAT 
5191 TRACHEA/ BRONCHUS DIS NEC 



DR.G 5A. MDC 04M, Bronchitis and Asthma, Age >=15 Without C. C 



Principal Diagnosis 



CPHA Abbreviated English Description 



0330 BORDETELLA PERTUSSIS 

0331 BORDETELLA PARAPERTUSSIS 

0338 WHOOPING COUGH NEC 

0339 WHOOPING COUGH NOS 

46410 AC TRACHEITIS NO OBSTRUC 

46411 AC TRACHEITIS W OBSTRUC 

4660 ACUTE BRONCHITIS 

4661 ACUTE BRONCHIOLITIS 
490 BRONCHITIS NOS 

4910 SIMPLE CHR BRONCHITIS 

49300 EXT ASTHMA W/0 STAT ASTH 

49301 EXT ASTHMA W STATUS ASTH 

49310 INT ASTHMA W/0 STATUS ASTH 

49311 INT ASTHMA W STATUS ASTH 

49390 ASTHMA W/0 STATUS ASTHM 

49391 ASTHMA W STATUS ASTHMAT 
5191 TRACHEA/BRONCHUS DIS NEC 



263 



419-177 - 84 -- 18 



DRG 6A, MDC 04M, Bronchitis and Asthma. Age >=15 And/Or C C 



Principal Diagnosis 



Code 



CPHA Abbreviated English Description 



0330 

0331 

0338 

0339 

46410 

46411 

4660 

4661 

490 

4910 

49300 

49301 

49310 

4931 1 

49390 

49391 

5191 



BORDETELLA PERTUSSIS 
BORDETELLA PARAPERTUSSIS 
WHOOPING COUGH NEC 
WHOOPING COUGH NOS 
AC TRACHEITIS NO OBSTRUC 
AC TRACHEITIS W OBSTRUC 
ACUTE BRONCHITIS 
ACUTE BRONCHIOLITIS 
BRONCHITIS NOS 
SIMPLE CHR BRONCHITIS 
EXT ASTHMA W/0 STAT ASTH 
EXT ASTHMA W STATUS ASTH 
INT ASTHMA W/0 STATUS ASTH 
INT ASTHMA W STATUS ASTH 
ASTHMA W/0 STATUS ASTHM 
ASTHMA W STATUS ASTHMAT 
TRACHEA/BRONCHUS DIS NEC 



DRG 7A, MDC 04M, Simple Pneumonia and Pleurisy, Age '.70 Without C. C 



Principal Diagnosis 



Code 



CPHA Abbreviated English Description 



0741 

4800 

4801 

4802 

4808 

4809 

481 

4822 

4823 

4828 

4829 

483 

485 

486 

4870 

51 10 



EPIDEMIC PLEURODYNIA 
ADENOVIRAL PNEUMONIA 
RESP SYNC YT VIRAL PNEUM 
PAR INFLUENZA VIRAL PNEUM 
VIRAL PNEUMONIA NEC 
VIRAL PNEUMONIA NOS 
PNEUMOCOCCAL PNEUMONIA 
H. INFLUENZAE PNEUMONIA 
STREPTOCOCCAL PNEUMONIA 
BACTERIAL PNEUMONIA NEC 
BACTERIAL PNEUMONIA NOS 
PNEUMONIA: ORGANISM NEC 
BRONCOPNEUMONIA ORG NOS 
PNEUMONIA. ORGANISM NOS 
INFLUENZA WITH PNEUMONIA 
PLEURISY W/0 EFFUS OR TB 



DRG 8A. MDC 04M, Simple Pneumonia and Pleurisy. Age >=70 And/Or C C 



Principal Diagnosis 



Code CPHA Abbreviated English Description 



0741 EPIDEMIC PLEURODYNIA 

4800 ADENOVIRAL PNEUMONIA 

4801 RESP SYNCYT VIRAL PNEUM 

4802 PAR INFLUENZA VIRAL PNEUM 

4808 VIRAL PNEUMONIA NEC 

4809 VIRAL PNEUMONIA NOS 
481 PNEUMOCOCCAL PNEUMONIA 

4822 H. INFLUENZAE PNEUMONIA 

4823 STREPTOCOCCAL PNEUMONIA 

4828 BACTERIAL PNEUMONIA NEC 

4829 BACTERIAL PNEUMONIA NOS 
483 PNEUMONIA: ORGANISM NEC 

485 BRONCOPNEUMONIA ORG NOS 

486 PNEUMONIA, ORGANISM NOS 
4870 INFLUENZA WITH PNEUMONIA 
5110 PLEURISY W/0 EFFUS OR TB 



IP 


1 •* 


c 


1 *» 


o 


1 <e 




l *** 




1 > 




1 Ol 


e 


1 f- 


£ 


1 -O 


I 


1 -O 




1 < 


<4- 


1 


c 


1 < 




1 I 




1 a. 


•0 


1 CJ 


c 




•0 


| 


tfl 


j 


c 


1 











*> 




u 




» 








c 






1 Oi 




1 "O 




1 


(. 


1 







*> 




ID 




(- 








CL 




tft 




Ol 




(T 




r 













MDC 


i on 




1 *> 


< 


I a. 


O 


1 t- 


O 


1 u 
1 in 


cr 

Q 


1 Ol 

1 a 




1 -C 




1 in 




1 '>h 




1 




1 Ol 




1 c 




1 LU 




1 "O 




1 Ol 




1 •*» 




1 m 




l 




1 > 




1 at 




1 <■ 




1 -0 




1 a 




1 < 




1 < 


m 


I X 1 




1 CL 1 




1 CJ 1 



X 

Z O x 
* Q 

z o 
3 cr t- 

cj 

r ~ 3 
« z 

x 1 1 

LU ir cr 

1 < < 

— 1 1 ( 

3 3 3 

a a a 
000 
z z z 



X I- 

Q If) (J 
UJ UJ 
O I- Q. 

1- cn 
Jiniz 
~ t- 3 
x o 1 
1 1 > 
cr cr k 
< < ~ 
_i _i > 
3 3 < 
Q Q t_> 
O O 
Z Z 3 



r z 

< * 
x z 

LU 3 
O Z 

z < 

I x 

> LU 
t- I 
—1 > 

> (- 

< -1 
CJ > 

< 
3 cj 



OOUOOOOO 

zzzzzzzz 

33333333 
— I — I — I — I I I I i 

nCOQmCQCDCSQQ 
t-t-t-l-HKKK 



X 


X 


X 








z 












z 


z 




X 






CJ 




























a 


Q 


Q 


Ul 






2: 


X 




X 


t- 


CJ 


< 


2: 


X 





X 


t- 


LU 


































UJ 




Z 


z 


O 


X 


Q 


cn 


UJ 


X 


z 


Q 






L0 


0. 






X 




X 


1- 






Z 













f— 


O 


1- 


CJ 


<£ 


3 




a 




LU 


LL 


UJ 


3 








Uj 


CO 


r 




Q 


X 


Q 


cn 






2: 


X 




X 


1- 


CE 


_J 


H 




yj 


X 




O 




O 




cn 






O 


_l 


□ 


t~ 


z 


< 


3 




a 




UJ 




Z 


z 


c 


X 


a 


cn 




3 


CO 


X 


EL 


UJ 


X 


cr 








z 


□ 


z 


cr 


=J 






3 






O 




O 


1 — 


CJ 


< 


3 




Q 








U 




t- 


cn 








_i 


cn 


X 


3 


z 


< 


CJ 





cn 


X 


1 


UJ 


r 


CE 


h- 


t- 




LU 


X 
















1 


X 





z 


O 


X 




3 


— 


t- 


1 


1 


X 


t— * 


1 






CO 




«£ 


U 


_j 


cn 


X 


C 


LU 


Z 


cr 




r- 




i 


> 


1 


1 




Z 


UJ 


E 


CJ 


X 


O 


CO 


cn 


UJ 


Z 


CO 


X 


□ 




O 


X 




3 






if, 




< 


CJ 


_J 


cn 


X 


f- 






h- 


1 


1 


1 


1 


1 


1 


1 






1 


1 




1 


1 


CO 


z 


LU 


z 


CJ 


X 


O 


z 


O 


X 




3 












1—3 


cn 


cn 


cn 


CO 


cn 


cn 


cn 


cn 


CO 


cn 


CO 


CO 


CO 


CO 




1 


1 


1 


1 


1 


1 


3 


z 


UJ 


z 




X 


O 


> 


> 


> 


> 





3 


3 




3 


3 


3 




















D 


t- 


h- 


:- 


h- 




t~ 




1 


1 


1 


I 


1 


I 


1 


< 


< 




< 


X 


X 


X 


X 


X 


X 




cr 


tr 


cr 


cr 


cr 


£E 


cr 


CJ 


CJ 





CJ 


CJ 


CJ 


U 


<t 


< 


< 


< 


< 


< 


< 


CJ 


CJ 


CJ 


u 


CJ 


CJ 


<J 


CJ 


CJ 


CJ 


CJ 


es 


£3 


£3 


£3 


£B 


£3 


a 


LU 


UJ 


UJ 


UJ 


LU 


LU 


LU 
























Z 


z 


z 


Z 


z 


Z 


Z 


»— 1 




t— * 








e— 1 




(=1 












Z 


Z 


z 


z 


Z 


z 




3 


3 


3 


3 


O 








O 





O 


O 


LL 


LL 


LL 


LL 


LL 


LL 


a. 


X 


X 


X 


X 


X 


X 


I 


O 


O 





a 


G 


c 


□ 










E 


cr 


cr 


cr 


tr 


cr 


cr 
















CJ 


CJ 


CJ 


u 


u 


(J 


O 


r 


r 


E 


r 


Z 


z 


z 


O 


O 


O 


O 


Q 


09 


£3 


£3 


S3 


£3 


£3 


O 


O 


O 





CJ 


CJ 





z 


z 


Z 


z 


Z 


Z 


Z 


3 


3 




3 


3 


3 


— 


Z 


Z 


Z 


Z 
















Z 


Z 


z 


z 


Z 


z 


z 








O 





O 


O 


c 


LU 


UJ 


LU 


u 


LU 


LU 


LJ 


3 


3 


3 


3 


LL 


LL 


LL 


LL 


LL 


LL 


LL 


3 


3 


3 


3 


3 


3 


3 


cr 


cr 


cr 


cr 


cr 


tr 


tr 


Z 


z 


Z 


z 


z 


Z 


z 


-1 


_l 


_l 


_J 


O 


O 


a 


O 


O 


□ 


O 


_J 


_J 


_l 


_I 


J 


J 


_i 





£3 


£3 


£3 


£3 


£3 


£3 


LL 


CL 


a 


CL 


c 


a. 




£2 


a 


a 


£3 


a 


a 




£3 


£3 


£3 


£3 


£3 


£3 


£3 


£3 


£3 


es 


£3 


es 


a 


£3 


£3 


£3 


£3 


£3 


£3 


£3 


£3 


£5 


£3 


£3 


a 


t- 


t- 


t- 






t- 


1- 


1- 










f— 


t- 


t- 


<r- 


t- 






t- 




K 


(- 


h- 




1— 




t- 


K 




t- 





rjn«Tin-oo — rd n«s-ir>oo-»rijn>3-in«oo — rjnvmoo — rjtn<»-in<;o— • n <t i~> -c 
^.^^^^rMrurii rjfiifiiriinnnnnnnfl-<r<ffl-<f»<tifiiriir>ir)iriinfi<i<i<<;<i^-o 



ooooooco 0000000000000000000000000000000c 



o 

UJ 
CL 

cn cn 
cn z 

LU 3 

o 1 
cn x 

CO LU 
< _l 
CL 

o z 
z o 

3 U 



Z x 

X 32 Q 
< Z 

x 3 O 

lu or 

Z CJ 

O X HI 

Z LU z 

I I I 

xxx 
LU LU LU 
-I _) _J 
Q. CL CL 

z z z 

000 

cj cj CJ 



x 1- 

x a co 

LU 
O t- 

_j cn x 

3 « 1- 

u x a 

1 1 1 

XXX 

LU LU LU 

— I I I 

CL CL CL 

z z z 

000 
o cj cj 



CJ 



CO £3 £3 £3 £3 £3 £3 



z 

cj < 
LU X 
CL LU 

in 

z o 

3 Z 
I I 
> > 

cn cn 
< »— « 
cr cr 
3 3 

LU LU 

—i _i 
cl a 

ffl co 



z 

s: x x t- 
z a x q cn 

3 O Lu 

□ O h- 

Z or t- t- 

< cj _j cn x 

x >-i 3 

LU Z U 

I I I 

> > > 

cn cn lo 



LU 



X o 

I ( 

> > 

cn in 



or cr or 

3 3 3 

LU LU LU 

I I I 

CL CL CL 

□ DO 

I — t— »— 



cr cr 

3 3 

LU LU 

_l _J 

CL CL 

CO CO 




UJ 

a. 
in 
z o 
3 z 

I I 

CJ cj 
LU LU 

z z 
co m 



o o 

o o 

or or 

CL CL 



Z x x x 

2: Q Q Q 
Z 

3 O I- O 

or _i t- 

z cj 3 cn 

< (j —> 

x r 1 x 

LU I CJ 1 

I CJ LU O 

<J LU Z LU 

LU Z Z 
Z £3 

£3 I— £3 

D (- h" 
t- O 

OOO 

or cr or a. 

CL CL CL CL 



I- z 

in ac 

lu z z 

1- CJ < 3 

LU X 

X £L LU Z 

1- in < 

Z O x 

1 3 Z LU 

CJ I I 



x t- 



Q x Q CO 

a lu 

o o K 

cr I- K 

u _i cn x 

x — 3 ~ 

LU Z cj I O 

I I I I I 

in cn cn cn cn 
□ 0000 

z z z z z 



£3 

LU 

z cr 
< o. 



EXZZZZEZZXEZZZXZXZXZ 



3 
I 

lu in cn 
zoo 
z z 

co 

H £9 Q 

C5 

cr>>>>>>> 
CLcrcrcrcrcrcrcr 
<<<<<<< 
zzzzzzzz 



cj < Z 

LL x 3 

a lu 

CO z 

^. O x 

t- 3 Z lu 



a x 
a 



cr t~ 

cj _i 

Z cj 

cr cr 



cj: z 

uj c < 

(- L. x 

CL ^ 

X i," 

1- z ~ 

C 3 Z 

1 1 i 



r- 1- t- < < 



co a £3 £3 a z Z 



z z z 



o c o 
z z z 

3 3 3 



LL O C 

z g r 
^ ^ i 



CJ CJ o o c c 



crcrcrcrcccrcccccccrcccrcrcccccrcrircrcrcrcrcrcrcrcrcr£2C3C3£3£3 

lLO.CLQ.Q.CLCLO.CLCLCLCLCLCLQ.CLCLCLO.CLCLCLCLCLa.CLCLHI-1-l-i- 



£3 CS £3 CS 



ru r»j 
— n ~o 

> o o 



2^S!3S!55 o * ,r ' in<firi ' 0Cl -' r ' in ' fir) < | O-riic , j'riri^o«riin'iiri^oH 
0000000000000000000000000000 — — — — — — — ~ — 

ooooooooooooooooooooooooooooooooooocc 



266 



c 
o 



c 

HI 
■o 

01 



0. 



' X X h 




LU LU 




cn 




<c 














< 


tn 


I 






cn 








Q Q cn 




D 3 


cn 


o 


z 




















cs 






LU 






tr. 


UJ 




O O 


< -1 


o 


O 


z 




o 


cn 




<s 




Z 


O 3 




tn 


tn 


LU 


CO 






2 


< < 


1-4 co cn <: 


> 


Z 


o 




z 








< 


o 




o 






D 


z 




I— 


_J (— 


a: 


X x t- _J _l 


cn oe o « — < 


z 


D 


z 




3 


(- 




z 




z 


_j 


CJ 




tn 


O 




t- 




3 in X E 


z 


Q x Q ID IL 1 


O < wo hzm 


o 


LU 


3 




_J 






o 


z 


3 


o 




< 


□ 


> 


tn 




z 


U » (- u < 




G LU 


Z « H > « O Z 


o o 


Z 


LU 






z 




z 


o 


LU 


z 


c 


or 


_l z 




z 


c 


I I O iii x 




O O K U Z 


z x u z z z o 


z - 


a. 


z 




_J 


o 






z 


Z 




o 


X 


_i 




Q 


G 


z 


03 1 1 0. UJ 


Z 


or h i- •-< o 


uu<<oo;zo 


3 o 


cn 


a. 




3 


z 




LU 


3 


a. 




□ 


i- 




cn 




Z 


3 


t- ca a cn 


< 


U JUJIZE 


OCCKQZE-^Z 


_l "-I 


cn 


cn 


z 


=3 


cn 


z 


LU 




o 


X 


z 


o 


> 


t- 


3 


UJ 


t- H Z O 


X 


ii D i-i K O 3 


0"IIO»DZ_D 


a 


a. 


< 


LU 


a. 


Z 


_i 


Lu 


3 


< 


cr 


cn 


o 


LU 


z 


_l 3 Z 


LU 


ZUIOZU 


<JhOI-_0.ZJ_« 


< 






tr 


z 






a. 


< 


Z 






LU 




LU 


Z 


a. 


< X I 1 1 


1 


1 1 1 1 3 z 


JDZXJZ QL 


a u 


u 


cn 


cn 


e> 


a. 


cn 


LU 




u 


o 


Z 


z 


a. 


X 


U. 


C 




UJ u u u u 


O 


UUUUUQ. 


_h<Z4_tn u. 


u 




o 


< 






o 


< 


_i 


tj 








tr. 




Z 




111 


X < < UJ UJ 


LU 


LU UJ LU UJ Z 


uj cn o cn o 


z 


r 




u 


< 


i- 




< 


o 


> 






< 


□ 




h- 


(J 


O CT OT Z Z 


z 


Z Z Z Z 0. > 


U>>>><_!>-' 


—i u 


tn 


cn 


z 


cj> 


z 


cn 


z 


z 


o 


(J 


< 


< 










z 


< t- 1- 




DC 


►-■criririr-jcncncn 


cn 


< 


< 




o 


tn 


> 


□ 


o 


□ 








z 


z 


z 


Z 


Lu 


K ta 03 


03 


>- < 


Z«<<<_l<0-' 


< > 




-I 


z 


u 


< 




z 


z 




3 


Z 


z 








c 


tn 






H (— f- Or Q 


□ ZZZZUIUIIJ 


or 


0. 


a 


o 


o 


-1 o 


3 


o 


> 




c 


o 








> 


CO 






4 Z 


rooooozt-i-i 


a < 


o 


o 


C9 


z 


a. 


z 


LU 


Q X 


z 


z 


z 


r 


z 


z 


\ 


Lu 


_J _l _J 0. 0. 


O. 


LL-Q.ZO 


3ZZZZ«H~X 


« z 


t- 


i- 


«t 




D 




z 


3 


a. 








3 


3 


3 


Q 


\ 


o □ O in cn 


CO 


in cn cn cn »- u 


ui_i_i_i_Jorcnz_. 


a -i 


cn 


cn 


IT 


X 


X 


LU 


a. 


LU 


< 


Lu 


u 




LU 


Ul 


Lu 


G 


_J 


cn cn cn lu lli 


LU 


LU LU UJ LU QC LU 


Z3333<IOor> 


< a: 






«t 


CJ 


a 


z 




cn 




z z 


z 


Z 


z 


Z 


O 




t=i c=j t-i E E 


or 


OC DC IT 0T 0. CO 


lLQ.a.Q.>-Ol0UIL 


X 


X 


a. 


LU 




0- 




a. 


tn 


a. 


a. 


a. 


a. 


a. 


a. 


u. 


O 



oooooooooooooooooooo 



in 


in 


































o 


rj 




•s- 


n 


o 








n 


m 


<0 




CD 


o 


—4 


m 


m 






o 




rj 


Til 


ru 




T 


«* 




<r 


«T 












ru 


n 


n 


CD 


CD 


CD 


CD 


CD 


CD 


CD 


CD 


CD 


Q 


o 














<r 








<d- 






>s- 


<T 


in 







Z 


X 


X 1- 




z 












z 
















o 




Z 












Z 




X 


r 


_: 


a 


x q cn 




< 


z 










< 


z 










X 




LU 






X 




X 


1— 


U 


< 


z 


Q 


u < 


z 




a uj 


LU 


X 




X 


X 


K 


LU 


X 


s: x 


X I- 








Q 




CL 


z 


z 


a 


X 


C 


tn 


LU 


X 






LU x 


3 


o 


O 1- 


a. 


LU 


z 


a 


X Q 


cn 


CL 


LU 


Z Q 


x o m 


z 










cn 


<: 


3 




a 




LU 


C 


LU 


z 


C 


0- UJ 




or 


i- t- 


cn 




3 




Q 


LU 


cn 




3 


Q Ul 




X 




C5 


1- 


z 


X 




a 




C 


h- 


tr 






cr 


in 


z 


u 


-i cn x 


z 


O 




o 


o 


i- 


z 


O 


O 


O K 


z z 


a 


X 


o 


tn 


3 




Z 


cc 


i- 


t- 




z 


G 






z o 


< 




3 t- 


3 


z 


Z 


or 


K 1- 




3 


z 


Z or 




O < 3 




D 


_l 


UJ 


1 




4 


u 


_j 


Cfi 


I 




Z 


X 




3 Z 


X 


z 


U I o 


1 


1 


< 


u 


_i in 


X 


1 


1 


< u 


_i cn x 


LU x 


o 




o 


h- 


tn 


O 


X 




3 




i— 






< 


z 


1 1 


UJ 


i 


i i i 


O 


u 


X 


»— i 


3 -i 




cn 


cn 


X l-H 


3-1- 


CL LU Z 


or 




t- 




LU 


z 


U 


z 


U 


X 


O 


a 


a 


X 




X X 


1 


X 


XXX 


LU 


LU 


LU 


z 


O I 


□ 


O 


o 


LU Z 


O X o 


cn < 


o 


_l 


tn 


X 


D 


1 


1 


1 


I 


i 


i 




»— 


LU 





«t < 


X 


«t 


< < < 


Z 


z 


1 


i 


1 1 


1 


z 


z 


1 1 


1 1 1 


z O x 


i—i 


3 




h- 


O 


LU 


LU 


LU 


LU 


Ul 


LL 






1 




or K 


cr 


or 


or or cr 






U 


o 


u o 


O 






tn tn 


in cn tn 


3 Z LU Z 




I 


O 


Z 


a 


Q 


Q 


C 


Q 


a 






E 




O O 


o 


a 


O O O 


03 





LU 


LU 


LU LU 


LU 





o 


o o 


o o o 


1 1 1 


i 


I 


i 


1 




D 


O 


C 


D 


G 


c 


< 


< 


h- 




X X 


X 


X 


XXX 


t- 


1- 


Z 


z 


z z 


Z 




h- 


z z 


z z z 


> > > 


> 


> 


> 


> 


o 


z 


z 


Z 


z 


Z 


z 


Lu 


LU 






(- H 


K 


\- 


1- 1- K 






















cn tn in in cn 


cn 


tn 
















X 


X 


X 




o o 


O 


o 


O O O 


> 


> 


03 


03 





Q 


> 


> 










t—i 








a 


X 


X 


X 


X 


X 


X 


U 


U 


(J 


cr 


z z 


z 


z 


z z z 


or 


or 




1- 


K 1- 


(- 


or 


or 


t- t- 


hhl- 


or or or 


or 


or 


or 


cr 


< 


< 


< 


<C 


< 


<L 


< 


< 


< 


< 


»- 


3 3 


3 


3 


3 3 3 


< 


< 










< 


< 






3 3 3 


3 


3 


3 


3 


cc 


cr 


cr 


cr 


CL 


cr 


cr 


3T 


01 


or 




UJ UJ 


LU 


LU 


LU LU LU 


Z 


z 


Z 


z 


z z 


z 


Z 


z 


z z 


z z z 


Ul Ul Ul 


LU 


U 


UJ 


UJ 


o 


O 


□ 


O 


G 


O 


G 




h- 






z z 


z 


Z 


z z z 


o 


o 


o 


□ 


o □ 


o 


o 


□ 


o a 


o o o 


1 1 1 


_J 


—I 


_l 


_l 


I 


I 


X 


I 


I 


I 


I 








«S 


a. a. 


a. 


£L 


a. a. a. 


z 


z 


z 


z 


z z 


z 


z 


z 


z z 


z z z 


CL CL a. 


CL 


CL 


CL 


CL 


1- 


t- 


h- 


H- 


1— 






-1 


_J 














_J 


_l 


_l 


-J 


_l _l 


_J 


J 


-J 


_l _J 


1 1 I 


























G 


G 


O 


5 


09 


C3 


OS 


CD 03 03 


3 


3 


3 


3 


3 3 


3 


3 


3 


3 3 


3 3 3 








a 





a 


09 


ar 


B9 


a 


a 


e 


a 


cn 


cn 


cn 


cr 


1- K 




1- 


1 — 1 — 1 — . 


0. 


a. 


0. 


0. 


a. a. 


a. 


0- 


0. 


a. o. 


CL CL H 


K K 1- 


t— 






I— 


t- 


1- 


f— 




ir- 


(- 













o>nriin»if)'00'<riin*iri-oo-i run«rin-0O'<njn<j'in<)o«rijn>Tin<io«njn 
Nr^r^ivr^Nr^mcDtDtDCDCDCDO-i> tM>t>0'fooooooc---"<-i-i«riiriirjrii 

=. =« ^ « ru cm ru ro oj cm rii nj ru r«j r»i ru rj cm fu ru re 

oooooooooooooooo ooooooooooooooooooooooo 



267 



DRG 9A, 

Principal Diagnosis (Continued) 



MDC 04M, 



Respiratory Infections and Inflammations 



Code CPHA Abbreviated English Description 

5079 SOL ID/LI Q PNEUMONIT NEC 

5 100 EMPYEMA WITH FISTULA 

5109 EMPYEMA W/O FISTULA 

5111 BACT PLEUR/EFFUS NOT TB 

5130 ABSCESS OF LUNG 

5,31 ABSCESS OF MEDIASTINUM 

7955 TUBERCULIN TEST REACTION 



DRG 10A, MDC 04M. COPD Without C. C. 



Principal Diagnosis 



Code CPHA Abbreviated English Description 



4911 MUCOPURUL CHR BRONCHITIS 

4912 OBSTRUCT CHR BRONCHITIS 

4918 CHRONIC BRONCHITIS NEC 

4919 CHRONIC BRONCHITIS NOS 

4920 EMPHYSEMATOUS BLED 
4928 EMPHYSEMA NEC 

494 BRONCHIECTASIS 

496 CHR AIRWAY OBSTRUCT NEC 

5064 FUM/VAPOR CHR RESP COND 

5069 FUM/VAPOR RESP COND NOS 

74861 CONGEN BRONCHIECTASIS 



DRG UA, MDC 04M. COPD And/Or C. C 



Principal Diagnosis 



Code CPHA Abbreviated English Description 



4911 MUCOPURUL CHR BRONCHITIS 

4912 OBSTRUCT CHR BRONCHITIS 

4918 CHRONIC BRONCHITIS NEC 

4919 CHRONIC BRONCHITIS NOS 

4920 EMPHYSEMATOUS BLEB 
4928 EMPHYSEMA NEC 

494 BRONCHIECTASIS 

496 CHR AIRWAY OBSTRUCT NEC 

5064 FUM/VAPOR CHR RESP COND 

5069 FUM/VAPOR RESP COND NOS 

74861 CONGEN BRONCHIECTASIS 



268 



DRG 12A, MDC 04M. Neoplasm 



Principal Diagnosis 



tooe 


CPHA Abbreviated English 


1 ADO 
X OeU 


MALIGNANT NEO TRACHEA 


1 AD1 
1 Oec 


MALIG NEO MAIN BRONCHUS 


1 OdJ 


MAL NEO UPPER LODE LUNG 


1 A1A 


MAL NEO MIDDLE LODE LUNG 


1 AT=i 
1 Oc D 


MAL NEO LOWER LODE LUNG 


1 AOQ 
1 Oe:o 


MAL NEO DRONCH/LUNG NEC 


1 ADO 
1 Oct 


MAL NEO DRONCH/LUNG NOS 


1 A^H 


MAL NEO PARIETAL PLEURA 


1 All 
lOJl 


MAL NEO VISCERAL PLEURA 


X O JO 


MALIG NEOPL PLEURA NEC 


1 A 1Q 
X OJ7 


MALIG NEOPL PLEURA NOS 


X OHe; 


MAL NEO ANT MEDIASTINUM 


1 Azn 

X OH j 


MAL NEO POST MEDIASTINUM 


i a a a 
X o**o 


MAL NEO MEDIASTINUM NEC 


1 AAO 

X oht 


MAL NEO MEDIASTINUM NOS 




MAL NEO THORAX /RESP NEC 


1 ICQ 
X OJ7 


MAL NEO RESP SYSTEM NOS 


1QC1 
1 V j 1 


MALIGN NEOPL THORAX 


1 07H 
I 7/U 


SECONDARY MALIG NEO LUNG 


1 07 1 
IT/ 1 


SEC MAL NEO MEDIASTINUM 


X ~ 


SECOND MALIG NEO PLEURA 


X 7 / J 


SEC MALIG NEO RESP NEC 


1 1 11 


DENIGN NEO TRACHEA 


clcJ 


DENIGN NEO DRONCHUS/LUNG 


i i nA 

C- 1 C *♦ 


DENIGN NEOPLASM PLEURA 


c 1 n J 


DENIGN NEO MEDIASTINUM 


1 1 OQ 


DENIGN NEO RESP SYS NEC 


X c- T 


DENIGN NEO RESP SYS NOS 


C J 


LIPOMA INTRATHORACIC 


c Jl 1 


CA IN SITU TRACHEA 


11 1 1 


CA IN SITU DRONCHUS/LUNG 


ill o 

c t J 1 O 


CA IN SITU RESP SYS NEC 


2319 


CA IN SITU RESP SYS NOS 


2 3 5 7 


UNC DEHAV NEO LUNG 


23!>n 


UNC DEHAV NEO PLEURA 


2359 


UNC DEHAV NEO RESP NFC 


r?:i r v l 


RESPIRATORY NEOPLASM NOS 


795 | 


APN PAP 5MFAR-0TH SITE 



DRG 13A, MDC 04M, Pulmonary Embolism 



Principal Diagnosis 



Code CPHA Abbreviated English Description 



4151 
95B1 



PULMON EMDOLISM/ INFARCT 
FAT EMDOLISM 



DRG 14A. MDC 04M, Respiratory Signs and Symptoms, Age <70 Without C C. 



Principal Diagnosis 

Code CPHA Abbreviated English Description 



78600 

78601 

78602 

78609 

7861 

7062 

7863 

7864 

78652 

7867 

7868 

7869 

79131 



RESPIRATORY ABMORM NOS 

HYPERVENTILATION 

ORTHORNEA 

RESPIRATORY ABMORM NEC 

STRIDOR 

COUGH 

HEMOPTYSIS 
ABNORMAL SPUTUM 
PAINFUL RESPIRATION 
ABNORMAL CHEST SOUNDS 
HICCOUGH 

RESP SYS/CHEST SYMP NEC 
ABN FINDINGS-LUNG FIELD 



DRG 15A. MDC 04M. Respiratory Signs and Symptoms. Age >=70 And/Or C C 



Principal Diagnosis 



Code 


CPHA Abbreviated English Description 


78600 


RESPIRATORY ABNORM NOS 


78601 


HYPERVENTILATION 


78602 


ORTHORNEA 


78609 


RESPIRATORY ABNORM NEC 


7861 


STRIDOR 


7862 


COUGH 


7863 


HEMOPTYSIS 


7B64 


ABNORMAL SPUTUM 


78652 


PAINFUL RESPIRATION 


7867 


ABNORMAL CHEST SOUNDS 


7868 


HICCOUGH 


7869 


RESP SYS/CHEST SYMP NEC 


7931 


ABN FINDINGS-LUNG FIELD 



DRG 16A, MDC 04M. Pneumothorax, Age <70 Without C. C. 



Principal Diagnosis 



Code CPHA Abbreviated English Description 



5120 SPONT TENS PNEUMOTHORAX 

5128 SPONT PNEUMOTHORAX NEC 

8600 TRAUM PNEUMOTHORAX-CLOSE 

8601 TRAUM PNEUMOTHORAX-OPEN 

8602 TRAUM HEMOTHORAX-CLOSED 

8603 TRAUM HEMOTHOR AX-OPEN 

8604 TRAUM PNEUMOHEMOTHOR-CL 

8605 TRAUM PNEUMOHEMOTHOR -OPN 
9587 TRAUM SUBCUTANEOUS EMPHYSEMA 



DRG 17A. MDC 04M. Pneumothorax. Age >=70 And/Or C. C 



Principal Diagnosis 



Code CPHA Abbreviated English Description 



5120 SPONT TENS PNEUMOTHORAX 

5128 SPONT PNEUMOTHORAX NEC 

8600 TRAUM PNEUMOTHORAX-CLOSE 

8601 TRAUM PNEUMOTHORAX-OPEN 

8602 TRAUM HEMOTHORAX-CLOSED 

8603 TRAUM HEMOTHORAX-OPEN 

8604 TRAUM PNEUMOHEMOTHOR-CL 

8605 TRAUM PNEUMOHEMOTHOR -OPN 
9587 TRAUM SUBCUTANEOUS EMPHYSEMA 



DRG ISA, MDC 04M. Pleural Effusion and Pulmonary Edema 
Age <70 Without C. C. 



Principal Diagnosis 



Code CPHA Abbreviated English Description 



5060 FUM/ VAPOR BRONC /PNEUMON 

5061 FUM/VAPOR AC PULM EDEMA 

5062 FUM/VAP UP RESP INFLAM 

5063 FUM/VAP AC RESP COND NEC 
5080 AC PUL MAN IF D/T RADIAT 
51 IS PLEURAL EFFUS NEC NOT TD 
5119 PLEURAL EFFUSION NOS 
514 PULM CONGEST/HYPOSTASIS 

5184 ACUTE LUNG EDEMA NOS 

5185 POST TRAUM PULM INSUFFIC 
7991 RESPIRATORY FAILURE 
9471 BURN LARYNX /TRACHEA/LUNG 



DRG 19A. MDC 04M. Pleural Effusion and Pulmonary Edema 
Age >=70 And /Or C. C. 



Principal Diagnosis 

Code CPHA Abbreviated English Description 



5060 


FUM/ VAPOR BRONC /PNEUMON 


5061 


FUN/VAPOR AC PULM EDEMA 


5062 


FUM/VAP UP RESP INFLAM 


5063 


FUM/VAP AC RESP COND NEC 


5080 


AC PUL MAN IF D/T RADIAT 


5118 


PLEURAL EFFUS NEC NOT TB 


5119 


PLEURAL EFFUSION NOS 


514 


PULM CONGEST/HYPOSTASIS 


5184 


ACUTE LUNG FDEMA NOS 


5185 


POST TRAUM PULM INSUFFIC 


7991 


RESPIRATORY FAILURE 


9471 


BURN LARYNX/TRACHEA/LUNG 



DRG 20A. MDC 04M. Interstial Lung Disease. Age <70 Without C C 



Principal Diagnosis 



Code CPHA Abbreviated English Description 



135 SARCOIDOSIS 

1370 LATE EFFECT TB, RESP/NOS 

4950 FARMERS' LUNG 

4951 BAGASSOSIS 

4952 BIRD-FANCIERS' LUNG 

4953 SUBEROSIS 

4954 MALT WORKERS' LUNG 

4955 MUSHROOM WORKERS' LUNG 

4956 MAPL BARK-STRIPPERS' LUNG 

4957 "VENTILATION" PNEUMONIT 

4958 ALLERG ALVEOL/PNEUM NEC 

4959 ALLERG ALVEOL/PNEUM NOS 

500 COAL WORKERS' PNEUMOCON 

501 ASBESTOSIS 

502 SILICA PNEUMOCON NEC 

503 INORG DUST PNEUMOCON NEC 

504 DUST PNEUMONOPATHY NEC 

505 PNEUMOCONIOSIS NOS 

5081 CHR PUL MAN IF D/T RADIAT 

515 POST INFLAM PULM FIBROSIS 

5160 PUL ALVEOLAR PROTEINOSIS 

5161 IDIO PULM HEMOSIDEROSIS 

5162 PULM ALVEOLAR MICROLUH 

5163 IDIO FIBROS ALVEOLITIS 

5168 ALVEOL PNEUMONOPATHY NEC 

5169 ALVEOL PNEUMONOPATHY NOS 

5171 RHEUMATIC PNEUMONIA 

5172 SYST SCLEROSIS LUNG DIS 
5178 LUNG INVOLV IN OTH DIS 
5103 PULMONARY EOSINOPHILLA 
71 mi RHEUMATOID LUNG 



DRG 21A, MDC Q4M, Interstial Lung Disease. Age >=70 And/Or C C 



Principal Diagnosis 



Code CPHA Abbreviated English Description 



135 SARCOIDOSIS 

1370 LATE EFFECT TB, RESP/NOS 

4950 FARMERS' LUNG 

4951 BAGASSOSIS 

4952 BIRD-FANCIERS' LUNG 

4953 SUBEROSIS 

4954 MALT WORKERS ' LUNG 

4955 MUSHROOM WORKERS' LUNG 

4956 MAPL BARK-STRIPPERS' LUNG 

4957 "VENTILATION" PNEUMONIT 

4958 ALLERG ALVEOL./PNEUM NEC 

4959 ALLERG ALVEOL/PNEUM NOS 

500 COAL WORKERS' PNEUMOCON - 

501 ASBESTOS IS 

502 SILICA PNEUMOCON NEC 

503 INORG DUST PNEUMOCON NEC 

504 DUST PNEUMONOPATHY NEC 

505 PNEUMOCONIOSIS NOS 

5081 CHR PUL MAN IF D/T RADIAT 

515 POSTINFLAM PULM FIBROSIS 

5160 PUL ALVEOLAR PROTEINOSIS 

5161 IDIO PULM HEMOSIDEROSIS 

5162 PULM ALVEOLAR MICROLITH 

5163 IDIO FIBROS ALVEOLITIS 

5168 ALVEOL PNEUMONOPATHY NEC 

5169 ALVEOL PNEUMONOPATHY NOS 

5171 RHEUMATIC PNEUMONIA 

5172 SYST SCLEROSIS LUNG DIS 
5178 LUNG INVOLV IN OTH DIS 
5183 PULMONARY EOSINOPHILLA 
71481 RHEUMATOID LUNG 



u 

UJ 
0. 

cn 
z 
3 



cj 
a 

3 
O 

3 

O 



0l 

cr 



at 
in 
o 
c 

o> 

in 



u 
m 
* 

a 



Ol 

c 



Ol 
4* 
IB 

> 
ft 
(■ 



< 
I 

a. 

o 



CO 

a 

« o 

CC UJ 

a. 

UJ CO 

CC Z 

O D 
CO 10 I 

o in in a 

cn«cDfoco<-> cclu 

atazMHQir o _i 

u >-i ec or « Q. 

UJ CC CE UJ 12 

a. UJ tr uj u I i- 

WUJOCCD>x> cs _l 
ZZ3IO"»UJ h 3 Q 

DOt-Ku-U-inin uj r uj 
in z 

zzzzzzzz zzou 

UJUJUJUJUJUJUJLU UJ UJ -J 0. 
0.0.0.0.0.0.0.0. a.Q.ua 

oooooooo o o 
z z 

~ -~ ~ ~ - ~ 3 3 

lotninwiocntotn in tn z z 
w ~ ^ — — cr a: 

(SDQQQDQO CO CO UJ UJ 

•^1— <»—<»— l»-H»-HHH»—» M M H l~ 

cctrcccccccccccc cc cc to tn 



z t- 

3 z 

z UJ 

ct z 

uj < 

« tn — 

cr -J 



cn in 

z z z 

u cr cc 

o. (- (- 

o in in 

. & «? 
z 

o in tn 

« z z 

t- cc cc 

< a. a 

u cn cn 
o 

JQQ 

UJ UJ 

CC z z 

llj w w 

X U- LL 

t— UJ 111 

O Q 

I I 

1 J J 

3 _i _i 

2 « « 

CC 

UJ I I 

H K K 

in □ □ 



(- 

2 t- 

~ 2 

□ « 
"5 O 
~ 3 

CC 

< _J 
_l <t 

D 2 

o CC 

>-> uj 

> t- 

< in 
_) o 
o cc 

□ a 

2 2 

cc O 

UJ CC 

H I 

cn u 

x x 

i- t- 

o o 



a 

UJ 

tn 
o 
_i 

cj 
i 

in 
□ 

X 2 

3 

2 > 

CC cc 

UJ 3 

H "5 

in 2 
cc 

UJ cs 

X 2 

I- 3 

O _) 



a 

Q UJ 

uj in 

in o 

o -I 

_J o 

U I 

I z 

z o 

o ~ 

tn < 

3 cc 

t- UJ 

Z CJ 

o < 

u -I 

cs cs 

z z 

3 3 

-I —I 



> CO 

CC 3 

3 t- 

"5 Z 

z o 

-i a 

CJ) o 

z z 

3 3 

_l -J 



Q 

UJ 

in 
o 
_i 

u 
I 

> 
cc 
_ 3 
•-i "5 
K Z 

^ l-N 

CC 

111 I I 

u o o 

4 <. < 

— I cc cc 

X X 

cs a. o. 

z < < 

Zi «-t >-< 
JQQ 



u 
O I 
UJ cj 
tn uj 
□ z 



in o 

3 x 
1 1- 

u <t 

z cc 

□ H 

CC Z 

CO -i 



z 

Uj 

a. 
o 

Z I 
UJ u 

a. uj 

o z 

I 

> 3 

cc z 

3 ~ 

3 

Z cj 

-i < 
cc 

tn o 

3 x 

x t- 

o < 

z cc 

a k 

cc z 

CO <- 



0. 

z 

< o 

uj cj 

x I 

CJ < 

< Hi 
CC X 
H CJ 

< 

LL CC 

o y- 

q a 

z z 

3 3 

a □ 

3 3 

Z Z 

UJ LU 

a. a. 

□ o 



u 

uj in 

z o 
z 

CS 

Z UJ 

3 UJ 

_! CC 



t— > 
Z Q 
w o 
CO 



X 

CJ > 

Z cc 

> o o 

Q CC t— 

O D < 

CO N. CC 

X « 

U. 2 2 cj 0. 

UJ CS CS < tfi 

1-1 CC UJ 

UJ UJ UJ K CC 

f- cr tr 

< O O Q B 
JU.U.LU. 



J a. 

c z 

a c 

Z cj 
UJ 

cs 

cc cr 

~ 3 

< in 



9 
(- 
O 
*> 
<0 

(• 

a. 
in 
01 

tr 

0l 

o 



Z 

«*• 
o 

CJ 

a 
z 



ru 
ru 

cs 
cc 
a 



ai 

"O 

o 

o 



cn 
C 
UJ 

■a 
ft 
-»-> 

> 
ft 
t- 
x> 

< 
< 

X 
a. 

CJ 



o -• ru n m 


<0 N 


CO 0* «-« •-» 


o -« rd 


t> 


o 




ru o — ru — 


t> ~* t> fli 


ru 




















« - ni n » n 


n * «r «t 


>r 




rj 


mnnno-fii 


rjnno 




o 


o 




CD 


a- 


O 


r. 


r». n n n 


N tv 


n n n iv o~ 


CD CO CO CO 


CD 






-< ^ «-< ru ru c ii 


ru ru ru <r 


<r 


CD 


T 




<* 




CO 




o o o o c o 


O O 


o o o o o n n 


«»■ * «f «t 


«J- 


<t 


o 


■0 *n *o *n *o *o 


>o -o 




O 


n 


n 


n 


n 


m 


o 


OP 03 tip CO 03 CP 


CO CO 


CO CO CO CO CO CO CD 


GO CO CO CO 


CO 


CO 


CO 


CO CO CO CO CO CO CO 


CD CO CO CD 


CO 


o 


cr 


o> 


cr 




CT 


o- 



CL- 



IO 

3 >- 

t- r 

4 O 

tn in 
□ 
t- UJ 
Z X 
< cj 
_l <t 
a. cc 
in t- 
z 

<£ O 
CC I- 

z 

CS UJ 
Z H 
3 t- 
_l < 



cj in 
UJ o 

tn z z 

o h t- 
z z 

CC UJ UJ 

w cs CS 

0. < < 

tn 

uj >- t- 

cc X X 
UJ UJ 

CJ 

zoo 
UJ z z 
cs o o 

O CJ CJ 
X 

cj a. a. 

> in tn 

tn uj uj 

o. cc cc 



z 

UJ 

tn 

UJ > 

a. x 
tn a. 
< z 

-I UJ 

_l 

□ -I 

cj < 

»— I 

> K 
CC "-• 
<t t- 

z tn 
o cc 
z LU 
_i t- 

3 Z 
0. •-> 



< 

Z 

111 u 

in « 

> _i 

X 0. 

a. cj z 

Z LU O 

UJ Z cj 



cs 

Z 
3 

-J 



> LU > 

cc tn z 
o < o 

h UJ h 

< in tn 
tn o 

Z Q LU 
LU X 

a. cs cj 
z z < 

O 3 CC 
CJ _l I- 



~> tn 
a 

tn a a 



z 

Z 2 



in in 

< < 

Q Q 

LU LU 

z z 



tn k 
cc tn 

LU > 

a tn 
cc 

o a. 

tn in 

t-i UJ 
O CC 



UJ 

in 

< CJ 

UJ LU 1-1 

in in t- 

<-. < cn 

Q LU > 

tn cj 
z « 

LU Q 



—I 
<t 

in in t- 
> « 

tn uj z 
rx uj 
o. i- cs 
in uj z 
LU n o 

CC K O 



cs tn 
z □ 

3 Z 
_) 

> 

LL _l 
O <t 

z 

tn o 

« 2 

tn < 

LU 

Z CS 
Lu Z 
CS 3 
< _J 



u in 

LU C 

z z 

> > 
_J —J 
< < 
u z z 
UJ o o 
z z z 

> 

-I > > 

< cc cc 
zoo 

o t- t- 
2 < < 

< cc cc 

o a. a. 

z m in 

D Lu LU 
-J CC CC 



z 

3 

z 
cc 

LU 
I- 

tn 

a 
z 
< 

z 

tn cs 
m < 

M cc 
CC X 
0. 

z z u. <. 

3 3 O « 

t- t— a 

«t < cn 

> Z UJ LL 
< — i-i O 

u cc 



X < 

LU CJ 

in in 

3 D 

(- t- 

u o 

LU LU 

a. a. 



< tn 
z UJ 
o -> 
z _i 

< < 
z 

X o 
I- z 
o < 



tn 

UJ 
X 
CJ 

z 

•- > 
a 
a. 3 
Z K 

3 tn 
to _J 
cc 

lu cc 
cs o 
z 

•-i cn 
u. tn 

< _ 
u. z < 
o z 

. o 
cs cs z 

Z Z _J 

•—<♦—» 3D 

a _j cl 
D _l 

3 UJ Z 

j 3 a 

cj to «t 



o 
z 

3 

LL 

> 
cr 



tn 

CO 

tn i-< 

CO 03 CC 

U II « 

lu cc cr at 

a. lu 

in lu o tr 

Z Z 3 X 

3 a i- h 



o o a a 

LU UJ U LJ 

tn tn cn tn 
o o o o 

t i — I — I 

uuuu 



cn 

CO 

CC CJ 
LU 
LU C 

cs tr. 
o z 

ID I J 

tn tn ra 

cd e cn >- cc uj 

« « a a □ j 

cc tr — a. 

cc uj iu i *- 

3 > x > c _J 
O — -> Uj — 3 

u. u. cn cn lu z 
o a c a a o 

Uj UJ UJ LU Uj LL 

cn co l" cn tn in 
o o o o o o 
_i _j _)_)_) _i 

CJ CJ CJ CJ CJ CJ 



X ~ ~ -~ — 

> in tn in tn 

x - -> " - 

o. a s q c 

0) _ _| _ « 

<t cc tr tr cc 



tn tn tn in cn in 
ca ca co co a co 
cc or cc cc cc cc 



o i> •>< ru o i ru n 

<io-oi>o-nffloriinviii(h<i<iri<)<iC)i>ocDnj^<irdOOOpo 

win<)iBCDajmroLD^i>thi>^thnQCD© 

>>nlnlnmlnlnmlnmlnlnlnlO^^^^^^ N ^^^^^^^^ II " IllIHD 



o — rur)«9-irior~-CDcr 
- o o o o c c 
pv iv r» rv 
o o o o o c 

CO CO CO CO CO IX 



275 



U 
u 



c 
4 

o 

rv 
ii 

A 

s. 
a- 
4 



* 

o 
c 

en 

a 



o 
« 

a. 
in 

01 

a 

Oi 



E 
* 

o 

u 
a 
z 



< 

n 

cm 

cs 

E 

a 



m 

in e 

Q Q 

~ o uj cn 

IT LU CD Z 2 

C QUI 

ui cn _i a. i- 

E Z U □ U) 
O G 

cn cn s: - - «a 

o cn cn n - 2 z 

cn>->crc3cn«criu oocn 

PSQ3a:>-'-'BacrO_i h h z 

cj •-• <-i E K m a. Ht-cr 

uj cr e uj or z t- ■- , 4 4 e 

a. uicrui lu 1 1- u u m 

tnwoirD>x> oj oo 

zz3io«-iu «:c jjq 

^OHI-ilLlflUlUJIlL LU 

cn z e e z 
ZZZZZZZZ ZZOUI ui uj - 

UlLUUILJUiUJ-UUI LUUJJU.I-XILL 
0.0.0.0.0.0.0.0. EEUGLDI— KUI 
OOOOOOOOOO UIOOQ 

- - 1 I 

£ £ u £ £ _i 

~^^.~~~~.~~.-D;5 G G _l 
cncncncncncncr.cn tnoizz J2Z« 
_• _ ~ ~ ~ ~ ~ ^^trtr^trcr 

OOOODBCO C3 C3 Ui LL' < Ul UJ X 

eeeeeeee EEcnwu.wcno 



o 
LU 
0. 

cn 
z 



£ t- 

3 Z 

z uj 

cr £ 

ui < 

K O 

cn «-i 



cn 
z 








































a: 


(- ~- 






































i- 


Z 1- 






































cn 


« z 

o <-> 


















_) 




z 




_l t- 




«J 








mS 


"5 O 
~ "5 




Q 




o 




ED 




Q 


1 




UJ 
E 




e cn < 

I LU Lu 




LU 
Z 


OS 




cn 
> 


CD 






UJ 


D 


Ui 




cn 


z 


LU 


o 




O 


< 


O X X 


cn 




z 




CO 


z 


E 




cn 


Uj 


cn z 




z o 


UJ 


cn 


UJ 


2 


1 


UJ 


O CJ O 


D 


cs 








E 


4 _l 




o 


CO 


O UI 


Z 


UJ _l 


3, 


O Z 


lU 


u 


X 


1 4 


X 


z 


UJ 




E 


CL 


_i < 




_j 


O 


_i a. 


UI 


0. CJ 


□ 


J 




0. 


u 


(J 


< E E 


o 




LU 






CO 


G Z 




u 


_l 


u □ 


Q, 


O 1 


1 


u 


"5 


□ 


z 


4 


UJDI- 


Z 


_l 


E 




E 




o cr 




I 


u 


1 1 


o 


1 > 


> 


I 


Z 


1 




E 


X 2> 


G 


"V 






cn 


a 


UI 




CD 


1 


z cn 


1 


z cr 


E 


> 




> 


"5 


h- 


uzz 


E I 






LU 


Lu 


> i- 




O 


z 


o o 


2 


O G 




E 




E 


z 




< _ _ 


C3 


U 


> 




E 


z 


< cn £ 


z 


o 


« z 


O 


~ -) 


g 




3 




u 


E 




Z 


E 




1 




JOS 






l- 




1- z 


z' 






-s 




O H H > 


> 


G 


C 


Z 


CJ 


u, 


U Ct Z > 


cn 


< > 


cn 


4 ~ 




z 


CJ 


Z 


u 




Z Q Q E 


h- 


in 




UJ 


O Q 


c 


e 


G 


cr cr G 


cr 






< 




< 


Q 


C - G 


G 


D 


< 






Q 


z z 


UI 3 


t- 


UI G 




u r 


z 




E 




a. 


Z 


Z ca 


a 


\ 


E 


5 


E 


1 


e o i- 


-5 


Z 


uiz 


u o 


o 


cn 


O 


cn 


c 




g u 




X 




r 


_l 


lu cr 


10 


z 


□ 


< z 


□ 


4 < 


< 


G 


I 


3 


X 


C 


o u z 


Z 




E 


c 






t- X 






u 


_l « 


O 


_l E 


E 




i- 


X (— 


3 


3 Ul O 


C5 


< 


U* 1 


r 


u 


t— • 


cn u 


E 










X 


X 


u 


4 


u 


< 








E 


LU 


Ul 








UJ 




o 


CS CJ 




CS E 


CL 


z 


E 


z 


E 


Z 


Z UI U! 


Lu 


H 


E 






X 


X X 


X 


2 


z 


z z 


z 


z 4 


4 


□ 


1- o 


1- 


Ll 


U' 1- E 


E 








E 


1- 


1- 1- 


r— 


D 


G 


3 G 


3 


G >- 




E 


z 


E 


Z 


E 


E 4 G 


G 


09 


Q 






□ 


O O O _l 


_J 


_l _l 


_l 


_J O 


c 


G> 




D 




D O _J U 


U 


U 


Lu 


< 


cn 



o-<CMn<3-iTj-or^GO- c « rj o- o - rj o - rj — o — t> ru re 

M ^^.-H-.«^-.-.-irLin«3-<ii^n<a-<9->9-TrjriinjnnGO — tMrjnno — oo — coon 

NNNI^r^r*NNNNNNr^t>l>CtlfflOGG'— — -h-n CM TJ Til CM CiiCii »CCG<f*TTaiN 

ooooooooooooonn^^^^^<i<i<i>o<3>o<i<i-o^>o<r^Nonr^nnL":o- 

OECD©CBCBGD03GGffiroGCrGCDGGGGfflGGGffiGOGGGGGGGOC>C>OC>C>t> 



t i on 






























£ 




























cr. 




CL 






























G 




























c 




rH 






























Z 






t- 






















t— 1 




fc. 






























E 






cn 






















E 


CJ 


u 






























Ul 






UJ 
























Uj 


m 






























t- 






2 






















U 1 


E 


4i 






























cn 






u 






















E 




Q 






























o 






z 












cn 








J J 


2 

2 


Z 

— ^ 


£. 




u 


cn 
























z 






t-* 


> 










a 


cn 


LO 










UI 




UI 


o 














o cj cn 




CJ 


CO 




4 








o 








cn 




c 


C 


cr.' 








•H 


cn 


cn z 


Z 




4 


4 








Ul £ Ul G 


CB 


Ul 


o 






2 




E 


G 






C 


a 


E 






cs 




O 


_J 




D 


> i-i 






Z 


r 








z cs z z 


Z 


z 


z 




cn 


CS 




Z 


t- 




(J 








E 


E 








E 


Ol 




Z Q K 






LU 


UJ 




(J 




4 


G 








C3 


2 




G 


cn 




Ul 


E 


E 


lU 














C 


< 


o z 


S 




CO 


CO 








Ul E Ul Ul 


_J 


> 


> 






E 


CO 


_J 






E 






UJ 


E 


LU 




ui 


ju 




UI 




h E LU 


UJ 


UJ 


> 


> 








cn I cn cn 




_l 


-J 




E 


2 


E 




o 




C n 


LU 


□ 


E 


2 


^ 


X 










cn 


CO i- 1 C5 


o 


E 


X 


X 




... 




4 E 4 4 


u 


4 


4 






E 


LU 


E 


z 




z 


2 


3 


I 


C 












T3 




O E 4 




cn 


E 


0. 


(J 


2 




Ul 4 Ul Ul Ul 




cs cn cj £ 


z 


£ £ U 


-z 


O 


C 


G 






a 


h- 




U 


Ll 


U"; 


LO 




2 


01 


t- 


ui cn 






£ 


~ 




O 




cn cn cn cn 




z o U! o 


o 


G 


g a 




Z 




LL 


























z 


X UI K 




_l 


UJ 


UJ 


2 


O 




— Q m ii 4 


cn 


G Z Z Z 


z 


1- 


t- 


e 




CO 






a 


a 


Q 


Q 


D 


Q 


D 


C 


C 


Q 




< 


(J E X 


X 


-1 










Cfi 


O Q Q Ul 


> 


_l 4 




4 


4 cn 




U 


CO 


> 




Ul 


LU 


LU 


U 


U, 


LU 


Ui 


Ul 


Ui 






_i 


4 UI 


LU 


□ 


_J 


> 


UJ 


> 




u cn 


CJ 


> > 




> 


Z LU 


u. 




4 


a 




CO 


LO 


CO 


CO 


LO 


CO 


cn 


cn 




CO 


> 


a. 


cr cj 




CJ 


4 


E 


cn 


2 


1- 


£ O £ £ « 




U _l _l > 


> 


4 




o u 


z 


< 




a 


a 


G 


c 


O 


c 


c 


2 


c 


C 


Ol 


cn 










o 


4 


□ 




G LU Ul Q 


_i 


O 4 4 E 


E 


O 


E _l 




a 




z 




_i 


_J 


— ' 




_J 


_l 




_i 






(. 


z 


Z Q 


O 


> 






UJ 




z 


z cn i- i- 


4 


£ £ O 


□ 


X 


4 4 


cn 






o 




CJ 


u 


O 


CJ 


CJ 


CJ 


CJ 


CJ 


C 


o 




< 


o ui z 


Z 


E 


M 


€ 


(Jl 


cn 




h ct cn cn co 




cn o o h 


t— 


UJ 


o Z 


LU 


cs 


6 


z 


4 






















J3 


E 


1- CIO 


□ 


4 


H 


cn 




□ 




1- Ul > > - 




— Z Z 4 


4 




o 




z 


z 


_J 
























< 




□ o 


o 


Z 


cn 


z 


a 


UJ 


cn 


cn q cn cn ui 


z 


cn 4 4 E 


E 


cn cn z 


_j 






G 


X 


























Z X 




G 


E 


UJ 




z 


4 


4 E M 


LU 


UJ i-i 




G G 4 


4 


a 


_J 


E 


> 


cn 


LO 


tn 


CO 


cn 


cn 


CT' 


cn 


UO 




4 


O 


UI CJ E 


E 


£ 


UJ 


E 


cs 


o 


t— i 


>-i O E E H 




Z CS O E 


E 


h~ 




£ 


ra 


_l 




X 






















X 


z 


i- > cn 


CD 






z 


2 


4 


Q 


Q CO CO CO LU 




ui z z cn 


cn 


U 


CJ X 


G 


G 


LU 


z 


E 


a 


a 


e 


EC 


a 


a 


p 




c 


B 


E 


G 


i- cn ui 


Ul 


G 


Z 


□ 


D 


E 


Ul 


Ul <-< Ul Ul "-■ 


o 


CS G G Ul 


LU 


LU 


Ul H 


Z 


_i 


3 


c 


cn 






















O 


-1 


4 e cr 


K 


E 




CJ 


-1 


1- 


z 


£ Q E E K 


CJ 


4 _l _J E 


E 


E E O 


4 <J 


cn 


4 


4 


E 


E 


E 


E 


E 


E 


E 


E 


E 


E 



u 








































o 
























o 




ro 


n 




in 


-0 




CD 


o 


C 


ti 




o 




CO 


o 


o 






cn 


o 


ru 


n 


«r 


CD 


0" 


o 






-0 


o 


DO 


O 


CD 


CD 


n 


<s 


in 


-0 


CM 


o 


o 


o 


o 


o 


o 


o 


o 


O 


c 


o 




■o 


ru 


LD 




CD 


m 


a 


5 


CD 


CD 






o 


L> 


l> 


o 


n 


CD 


CD 


CD 


CD 


CD 


CO 




=r 




■0 




^0 




o 


IV 


fv 


N 


N 




iv 


rv 


IV 


[V 


*v. 


(■ 


o 




in 


o 


o 


o 






















n 


<s- 


«r 


«* 


«r 




<3" 


in 


u-3 


m 




CD 


CD 


o 


o- 


o 


o 


O 


O 


O 


o 


o 


o 


o 


c 


E 


<J 


> 




n 


in 


in 




in 


m 


in 


m 


in 


m 


in 


m 


m 












IV 






rv 






|v 


(v 




rv 


CD 


OD 


CD 


CD 


03 


CD 


CO 


CO 


CD 


m 



276 



Replication 
Physician Team B 



MDC 04: Diseases and Disorders of the Respiratory System 



DRG 


IB, 


MDC 


04P, 


Resection 


Pr oc edur es 




DRG 


2E, 


MDC 


04P, 


Other Resp 


iratory Operating Room Procedures 


non 

Lm \s 


in 

JO I 


nut. 


A A M 


As t h ma and 


Acute Bronchitis, 


Age o— 1 b 


nor 


AT3 


Mnr 


A AM 


A s t h ma and 


Acute Bronchitis* 


Age 16-49 


HDP 






A A M 


nsin ma ana 
c r 


Acute Bronchitis, 


Age 50-99, Without 


Ur\. 


AP 
OU i 




A AM 


nsxn ma a n □ 

r r 


Acute Bronchitis, 


Age 50-99, And/Or 


np a 


7P 

. / 13 / 




AAM 


Pneumonia, 


Age 0-15 




DRG 


8B, 


MDC 


04M, 


Pneumoniai 


Age 16-49, Without 


C. C. 


DRG 


9B, 


MDC 


04M, 


Pneumonia, 


Age 50-150, And/Or 


c. c. 


nc n 

JJn. \jr 


1 nn 

1 Ul3 I 


Mnr 


AiH M 


Pncumoniai 


Age 50-150, Without C. C. 


nc a 


1 1 13 , 




AAM 


Pneumon ia, 


Age 50-150, And /Or 


c. c. 


r>& a 


1 TP 




AAM 


Neop lasm 






no r\ 

UK <jr 


1 

1 JU , 


Mnr 


AAM 


Neoplasm With Bronchoscopy 




r>c a 


1 AP 
1 *H3 , 


Mnr 
nut 


AAM 


Chronic Obstructive Pulmonary 

C. C. 


Disease Without 


DRG 


15B, 


MDC 


04M, 


Chronic Obstructive Pulmonary 


Disease, And/ Or C 


DRG 


16B, 


MDC 


04 M, 


Spontaneous Pneumothorax 




DRG 


17B, 


MDC 


04M, 


Painful Respiration 




DRG 


18B, 


MDC 


04M, 


Pu lmonar y 


Embolism Without C. 


c. 


DRG 


19B, 


MDC 


04M, 


Pu lmonar y 


Embolism, And/Or C. 


c. 


DRG 


20B, 


MDC 


04M, 


Other Respiratory Diagnoses 





277 



REPLICATION 
PHYSICIAN TEAM B 
MAJOR DIAGNOSTIC CATEGORY 04 t 
DISEASES AND DISORDERS OF 
THE RESPIRATORY SYSTEM 
SURGICAL PARTITIONING 




DRG 1 B 



278 




419-177 O - 84 -- 19 



SaSOKPYIQ 



HSiT omg 




HoixvHiasra 

TMHIVd 



ZYHOBAONQZHd 



SQ03HY1HQJS 



asv asig AHYNowraa 

1AI1D0H1S30 DIHOHHD 



> 

as 
o 
o 
u 

< 

u 
a u 



X H 

< to 

u o 

. E- 1 Z 

2 z «e 

a w O 

Ses 

280 



as u 
uHO 

Q*W Z 

a x IH 
O w Z 

(A « 

M X « 

o as H 
z < as 

< 05 s 

u w J 

w " < 

< os u 
u H 

J s u 

Q Eh X 




E 
0> 

4-> 

(/) 
>> 
CO 



io x»- z zz x v-> zx xt- r a: 

w Q-O *x »<Hj<^xOXi-'aJ 2 Z^axQ^J<Z -><Z 

— UJ ZZ3X3V)iUXZ3 OtOO. ^ X XH» Z 0<Z 3 uuudXj^X K^aiK^X XH 

O JfJ<J -J J — JJ1C^3X3/l a£X Xt— jjxjj 'jHiLii^JK3^aJJZ3XJ'/i 

£ »— UX O Z5*-yi 3JOfZ<3 3 Oi XZ3XXV/13..U 3C*-»- •/> 3 3 -UO 3 3 JJ 
cc ^X3.JZJC>-^ ZaZX3^ 3K J 3<-_><3 Q JJ^> ZJJ/IZZ3 3 3*-Z3 3 3 — 

— i »-v> <JJ^Z3Z<<JJ^XI JU£Xr>»- oiX J Jf-^ .3«-*.Z»~— 3Z£JC<- *- 3ZXj£*-»- wJ 
<U _ I i x— I — 1-^> < U _J X 3. -UX 3ZXZJZ3I I <U J^Z I I<J_J^XjJ 

5 o ' I 3ZiJZUZ3^H'».UZ>1Za-3X«3-'-«') <JJ<^ZI I JM I I JJX-"D-.f-u1^X-cJ-^i 
•3- I I I I I I I— I I — I I •y)ZjJtJI3Z3K-3-»-XXl XXKXjjojjjZ JI303JJZJI0>1 
<4- 4-> — Ocot/»i/v/v-'V/vot/i.>v./*i/>*0'<i I lilt l 3ZjjZJZ3<<<«<«ZZi I I I I ZZ I I I i IZ 
O a»33333333333J33'-^'"->-^'- I I I I I I t XacxXiXXX. J JJJ J yrt*OwO;yvyi3 

T <<xixizizxxa£xxjcxuoojJuu«««<3333a33JJiJujjjuiujjjaaa3333 i 

r u -* 1 -»^<J | ~> JISiJfflaja.^.-nujJLlUJaJjJUJ — £X£<CXXX»^^^£^^r- ^zxx.xx>- 

53 J, ZZ^ZZZZ"«^MH«^«N**riwM«zZZZZZZP->«cfH^ uo 

-o <u zz3333333xim.4.a.a.u.xxxzzxz33333333333333>*>aaaaa»-aaaaa-< 
s_ o ucocae'JtaccrEX ■j'jwjjuui.ij.i.i.i.i.j.iij.a.xj.xispf^fxxt-fi-'-'-i 
° _ jjasoaaaaouuuooozzzzz^^JJ3J333jj3^3J3« x< x> 

"ft ZZ ZZZZZZZ3333033JJiJJuJ4J4JX:UJJjJ4jiiijJUJZZZZZZZZZZZZZZiJ 
Q ~r- 33XXXI1XXX3333333XXXJCXXZZZZZZZZZZZZZZZ33J33333333333J 

i— jjjujuujjjjjjjjjsso<ssaj9au.(iaiU.aaau.a.au.aaxxxzza.xzz£xxxxa. 
"O en jjjjjjjjjjjjjj 

c c ajj}Xjax)iuaoaaa3ja)9aaaaaja>aaaaxiaaaaaaaxis9iua-;^^^^_>j^33w^a 



CO 



«3 



CO 

<=> <- 3339333333303030333333333333303333333030333030J33333 



u 

<£ ZX XK X XX X>— JTZXXXH- z zx X^ X X^ xzxx 

Q Z^3X3wOj<Z333^U<^333^ *X X*- Z^SXSVI ZZ3K3^U<^33 

un U<Z 3) JJUJX ^ -UJJXZ JJ ZZ3X3^IJ<Z 3 -U . J < ^ O lUoJXZ 

T= Z5^ XIX3J 3*-0.iUZ3*-0*-a.;Xl33*-0>-*J<3 a JJiiX33 3h>iJXZ3 U^X-lOJ*- 

^_ »-x < a. jj 3C^-t— •/> 3)ac_j^- v> tc_jh- _ux -3 a^-o-iu ■x*-*- 3»x»3T£»— </) qcj 

1— <3 — '.0*0 ZJJ^IZJ J3^ZZ3£J3^ZXOJZXH»- -O ZJJtflZ'" JJ^ZZ3ZJ3 

cn «-«- Zifl23X>-3-«'-3Z£«J-'-JZ<-«U-»'-V> < JJ/1XZ3X^3-«>-Z3Z-<J«*-3Z<- J 

C ^Ov»3J^jj34C jja.-)X_l I KZIZJI I XZ I X J4UXM Jx^J^ U£UXJJ^4£U1J I 1X2.1 

5- 1 1 1 1 1 1 1 >->-x i >» 1 1 uuai 1011 Dz-ijzjza 1 1 1 1 1 1 1 1 1 x 1 1 1 1 >->- xi 1 >• 

JZ O '~- u Ji/IXXXXXXXVII/l'JJi/IV)i/li/)|U.U ) JJUJ I I I I I I I XXXXX t'XXXiUIXXX'-'- I '*'" 

-t-> «r- ZX^-OJXiJJ XJoJXJ I — <— ■uajwrwu^l WT/lr-f— r— f— r— *—r—^ 4 I — 

•!~ *J JJZ4 _J_j J-I_J_J_J 1CXTC X TCeX -U-2 ZZJJJJ3a3JJJJJJJjJJJJJJ»->> 

5 f-J^JJJ. 3.^0.aill33JJ3JJa3^ a ZZZZZZZ-<-<"»"<-«"<-J33JJJ3<il-« 

^ s_ a. tu- jzxcczz x-J uxj xjjjxi uf- flfua xa.xxu.xxao j-jaaa j'J> j j 

a) u^>-fl4Z3333a30JjjjjjJ can- h-f- oaaaaaazzzzzzz jo'33333 < 

"O if»Z 3J3JJJJJJ JllllllUJ^ J f-r-*-*-*-t-»-— ZZZZZ ZZXXJXIE 

° ° < 3^1-1 _) 33 J3JJ 

w jc>— 1 3a'OflaT3Sflaa3Baaxx"ZZXxz»>'>^>'^JJJjJJJJ3JJjJJjjjJo 

21 <— >ZJ'"'-'-'-t-'-'— — llXllXlXXXXXXX^ZZZZ^^Z^^Z^iiiZZ^Z 

O </> »<«<«3333333333333333333 

T jjjuiizczri:r tzttiz^ZEj: xxxx xxxxu ujjjjjjjjjj _i _j _j — i — < — < — i 

q £ 3«— o^xrjc.-jCTCxaCTOCJOCacac.zacJC ^zx^tziczttzxzzixaaaaa o aaaaaana a-oaaa 

o u_ j<J/i<aaia.iiiQ.iiiiiiiiiiiaia.ao.iiiir— f-i—i ■ — »- — ,— 



I OS 



q f\j OH\j^^ino3HN^r^oo^'\ifl*'.ftao»<Ni'iT/io3^'vi , n*."i<)jH"gfl*f\o3-<N.' , U' 

0ON->JT333O333^-Hrt-»-Hrti3a30aO O J^lM?3>J>a , (r330a030-'-<H-i-.-i-<ftj-yjTj^.\ 
■t-> «)'NJ^-«'n>00003Q00303^03053000033333333— <h-hh-<hhhhh-ihh-<-<-»n 

^ 3»>33333330303333333333030033 30300333000033330000333 

1= 

00 



281 



Table B 

Code English Description 

01201 lb PL EUR 1 S Y-NL t X AM 

01202 lb PLtUh I SY-tXAM UNKN 

01203 Id HLEUklSf-MlCkL OX 
0120H Id PLEUKlSY-oLLT OX 
01205 lb PLtUkiSY-Hl SICLUG OX 
0120b 10 PLEUklSY-Llh TEST 

01210 lb IHlkaCIC NLLES-UNaPEC 

01211 Id 1HLKAX NUbE-Nd t X AM 

01212 lb IHUkAX NUbt-bXAM UNKN 

01213 lb 1HLKAX NbLE-MlCRU OX 
0121<i lb IHukAX NUUt-CLLI OX 
0121b lb 1HLRAA NULb-HlilU OX 
0121b lb 1HLKAA huuc-UIH IbSl 

01220 1 bOl IR AC Ht AL lb-UNbPEC 

01221 ibUL IkACHbAL IB-NU bX AM 

01222 IbUL IkACH 1 d ° fc X AM UNKN 

01223 ibULAl IKACH Ic-fclCKU OX 
0122H IbOL InACHbAL TO-CUlT OX 
0122t> ibULAl TkACH ie-HlSlO OX 
01226 liOLAl IkACH lfc-LTH IbST 
01260 KbbP lb NbC-CNiPbC 
Ol2bl kbSP lb NEC-NL b X AM 

01202 ktSP lb NbC-cXAM UNKN 

01203 klSP Id NbC-MllKC OX 

01204 KbbF lb NbC-CCU OX 
012bt> kbbP lb NbC-hlbTL OX 
Ol2bb RbbH lb NbC-Llb IbbT 
0<03 PRIMARY PNcLMLMC PLAGUE 
0201 btCuNOAK Y PkcLKON PLAGUE 
020? PNt CMCN1 C PLaGLE NOS 
0212 PULMONARY TULAREMIA 
0*21 PULMONARY AMHRAX 

0310 HULMdNAkY MYLCBAC IERI A 

0330 bOkOtlELLA FtRlUSSIS 

0331 dLkbc IcLLA PAk APbR TUSS1 S 
033b WHU0P1NG COCbH NEC 

0339 mHOLPING CUUoH NOS 

0391 PuLHONAk Y AC 1 1 MjMYCUS 1 S 

0521 VAk 1CELL A PNcLHONllIS 

0551 POSlHbASLES PNEUMONIA 

0730 LkNiTriOSIS HNELMLM A 

0741 tPlLEMIC PLtCKCOYNlA 

09d1 SYPHILIS OF LLNG 

1124 LANLlbiAalS LH LONG 

1 140 PklhAkV CUCCIGIOIUGMYCOS 

1 1505 H1S1UPLASM C AH S PNEUMON 

11515 H1S10PLASM Ubb PNECMONl A 

11595 HISTOPLASMOSIS PNEUMONIA 

1212 HaRaGLMMI Ablb 

1221 tCHlNcCOCC GKANUL LUNG 

1304 lUXuPLAbMA FhtlMONlTlS 

135 bAkCUlDObla 

1363 PNEUMLLYSTLb 1 S 

1370 LAlb tHFECl Ibi RESP/NOS 



(Continued) 

Code English Description 

lo20 MALI GNAM NEO IkACHtA 

1622 MAL1G NEU MAIN bkUNCHUS 

Ib23 MAL NEU UPPtk LUbb LONG 

1624 MAL NbO M100LE LUbb LUNG 

1o2d MAL NEU LOkER LUBE LONG 

lb2d MAL NEC bKGNCH/LUNG NEC 

lo29 MAL NEC bRCNCH/L ONG NOS 

lo3U MAL NEC PAKIblAL PLEUKA 

lo31 MAL NEU VISCERAL PLbLRA 

lb3b MAL 1 G NEOPL PLEUKA NEC 

163** RALlu NEOPL PLbUkA NCS 

lb42 HAL NtL AN 1 MEDIASTINUM 

lb43 MAL NEL POiT MtOlAbl 1NUM 

164J MAL NbU MbOI AST 1NUM NEC 

1649 MAL NEC MEOIASIINUM NUS 

1650 MAL NEC TMLk AX/RE SP NEC 
1059 MAL NEU RE SP SYSTEM NUS 
1951 MALIGN J-EOPL THUkAX 

1970 bECCNOAHY MAL1G NEU LUNG 

1971 SEC MAL NEC MEDIASTINUM 

1972 SECCNO HAL 1G NEU PLELRA 

1973 SEC MAL 1G NEU RESP NEC 

2122 BENIGN NEC TRACHEA 

2123 BENIGN HEU BRUNCHUS/LUNG 

2124 BENIGN NEOPLASM PLEURA 

2125 bENIGN NEU ME01 A bl INCH 
212b BENIGN HEO RESP SYS NEC 
2129 bENIGN HEO RESP SYS NUS 
2133 , BEN NEC R IBS/ST ERN/CLAV 
2142 L1PCMA INTRATHORACIC 
2j11 CA IN SITU TRACHEA 

2312 CA IN SITU BRUNCHUS/LUNG 

2:>ld CA IN SITU RESP SVi NEC 

*31* CA IN SITU RESP SYS NUS 

2357 UNC BEHAV NEU LUNG 

2350 UNC bbHJV NbU PLbURA 

2359 CNC bbHAV NEU RESP NEC 

2391 RESPIRATORY NEOPLASM NUS 

3061 PSYCHOGENIC RESP1R 01S 

4151 PLLMUN EMbUL 1 SM/ INFARCT 

46410 AC TRACHEITIS NO UbSTRUC 

46411 AC TRACHEITIS W UBSTRUCT 
4o60 ACL TE BRONCHITIS 

4661 ACL IE BRUNCH 1UL 1 1 IS 

4600 ACENUV 1 R AL PNEUMONIA 

4b01 RESP SYNCYl VIRAL PNEUM 

4002 PAR INFLLbN/A VIRAL PNEUM 

4bOd VIRAL PHEUHUN1A NEC 

4b09 VIRAL PNEUMONIA NCS 

4bl PNEOMUCCCCAL PNEUMONIA 

4020 K • PNECHOMAE PNEUMONIA 

4021 PSELOOMCNAL PNEUMONIA 

4022 H. INFLUENZAE PNbUMON I A 

4023 STREP1CCLCCAL PNEUMUMA 



282 



Table B (Continued) 



4o29 

463 

4841 

4d43 

4d«i5 

HtiHb 

Hem 

48S6 

465 

466 

4870 

490 

4910 

4911 

4912 

4918 

4919 

4920 

4928 

4930C 

49301 

49310 

49311 

49390 

49391 

494 

4950 

4951 

4952 

4953 

4954 

49d5 

4956 

4957 

4958 

4959 

49b 

5C0 

501 

5C2 

503 

504 

505 

5060 

5C61 

5062 

50bj 

5064 

5069 

5C7C 

5071 

5078 



English Description 

APHILOCOCCAb PNbUMUNl A 
bACTtRlAb FNblMNlA NbC 
bACIth ImL HNcirUMA NUS 
PhbUMuM A : bRGJNISM NbC 
PwECM h CYlLPtG lNCb (Jib 
PNbtMUNIA IN hhOLP COUGH 
PNbUMLN 1 A IN ANT HK AX 
PNbCM IN ASPtRGlbbUSIS 
PNtUH IN OTH SYS MYCLSbS 
PNbLM IN lNFtC I UiS NbC 
riRONCbPNhUMuNlA bRG NJS 
PNtUMUN A A t lkGANISM NUS 
INf-LlitNZA HUH PNbLHUNl A 
bkUNChlTIS NbS 
jlMbLb CHR bkbhChlTlS 
MUCLPLRUb CHK fckLNCH HIS 
UbSTKUCT ChK thONCHlTIS 
CHKCN1C dRuNChlTIS NEC 
CHKUN 1C bKLNCHMS NOS 
thPHYSLMAlLGb Bbbd 
bMPHY SbMA NtC 
t AT AS1HMA R/b SI AT 
W STATUS 
k/b STAT 
h STATUS 
STATUS ASTHM 
ASTHHAT 



ASTri 
ASTH 
ASTH 
ASTH 



bXT ASTHHA 
INT ASTHHA 
INT ASTHMA 
AbThHA W/U 
ASTHHA k STARS 
bkUNCHlbCTASIS 
pAKHbkb* bUNb 
bAGASSUSl S 
blRU-FANCltRS 1 LCNG 
iUBtRGSlS 

HACT WORKERS* bUNG 
MUSHRUUM WGRKbkS* bUNG 
MAPb BARK-SlRlPPRS 1 bUNG 
"VtNT IbATlUN" FNEUMUN 1 T 
AbbbKG AbVEbL/FNbUM NbC 
AbbbRG AbVbCb/FNbUM NUS 
CHK AIRWAY UoSTRlCT NbC 
CUAb riUkKcRS ' PNbUMUCQN 
AibbSTUS IS 

ilblCA PNECPuCbN NEC 
1NUKG UUbT FNcbMCCUN NbC 
OUST PNtuMONUF ATHY NEC 
PNtOMLCUNlLSlS NCS 
FUM/VAPUR tikLN l/PNEUMUN 
HOM/VAPUK AC PbbM EDEMA 
FUM/VAPUk UP ktSP INFbAM 
FUM/VAP AC KcSF CLNU NtC 
FUM/VAPUk ChK RESP CCNU 
FUM/VAPUk KtbF CLNU NUS 
FUUL/VUM1T PwtbMQNlTlS 
UiL/bbSbNCb PNbUMUNlTIS 
SULlU/blO HNcCfOMT NbC 



Code English Description 

jUdO AC PUb ^ AN IF U/T RAU 1 AT 

5081 CNR PUb MaMF U/T RA01AT 

5088 ktSP CUNUX bXT AGlNT NbC 

5089 RbSP CONU: bXT AGENT NUS 
5100 tMFUMA klTH FISTUbA 

5109 thPYbMA H/C FISTUbA 

5110 PbbUklSY k/U bFFUS UR T8 

5111 B/CT Pb EUR/bFFU S NUT T8 
511d PbbbRAb bFFUS NbC NUT Td 
5119 PbbUKAL EFFUSION NUS 
3120 SPENT TENS PNEUMOTHORAX 
512b SPGNT PhbURUTHURAX NbC 

5130 AbSCbSS LF bUNG 

5131 A6SCESS LF Mbul AST INCH 
!>14 PbbM CGNGbST/HYPUSTASIS 
515 PU S T INF b AM PUbM FlbRCSlS 

5160 Pbb AbVbULAR PRUTblNUSIS 

5161 1C1C PUbM HbMUSlDLRUSIS 

5162 Pbbf AbVEGbAR MICkUblTH 

5163 1010 FieKUo AbVbUblT IS 
3l6d AbVECb FNbbMUNUPATHY NEC 
5169 AbVEOb FNtbMUNUPATHY NOS 
5171 RHbbMA TIC PNEUMONIA 
517* SYST SCbbkOSIS bUNG OIS 
5178 bbNG INVUbV IN OTH U1S 
51bO PbbPUNARY CObbAPSb 

5181 INTbRSTlTlAb bMPHYSbfA 

5182 CLMPENiA TORY EMPHYSEMA 

5183 PlbPONAH Y bUalNUPHlb IA 

5184 ACUTE bbNG EDEMA NUS 
olbb PCS 1 TRIUM PUbM 1NSUFF1C 
51dd bbNG DISEASE NEC 

5190 TfiACHEC ! TOP.Y CUMPblC 

5191 TRACHEA/bkONCHUS UIS NEC 

5192 MEC1AST 1N1TIS 

5193 MEDIASTINUM DISEASE NEC 

5194 ISCROERS CF DIAPHRAGM 
3l9d RESP SYSTEM DISbASb NEC 
5199 RESP SYSTEM OlSbAbb NUS 
71481 kHECMATClD bUNG 

7336 T lfclZt • 5 DlSEASb 

7484 CCNGbN 1 T Ab CYSTIC bUNG 

7485 AGbNtSIS OF bUNG 

74860 bUNG ANCMAbY NUS 

74861 CONGEN tkONCH 1 1 C T AS 1 S 
74869 bLNC ANCMAbY NbC 

7488 RESPIRATORY ANOMAbY NEC 

7489 RESPIRATORY ANUMAbY NUS 
75481 PECTUS EXCAVATUM 

754d2 PECTUS CAR1NAIUM 

7563 RIB SlbkNUM ANUMAb NEC 

7566 ANOMAblES bF DIAPHRAGM 

7dl5 CbbBBINC OF FlNGbkb 

78600 kbSPlRATORY ADNURM NUS 



283 



Table B (Continued) 



Code English Description Code 

76oUl HlPtRVtNT I LA J 1 IN b074 

7o602 OKTHOPNt A b39ol 

76609 Rt SP 1 R aTOR Y Atif^ORM NEC 6j971 

7bbl blRlbLR b4d3 

76t>2 CUUGH 64b40 

7663 HtMLPIYblS t>464 1 

7(364 AoNORMAL SPUTUK B4642 

78652 PAINFUL RE SF 1M 1 ION d«ib49 

Itibb CHtSl SWELL1 ft G /MASS/ LUMP boOO 

7667 AbhOKMAL CHEjT SCUNOS b60l 

7dtob H i lCUUGH do02 

7db9 RtSP Sfa/CHtaT SYMP NEC 6603 

7SJ1 AbN F lNUlNGb-LLNG FIELD b604 

7942 AbN PULMONARY FUhL STUDY bbOt> 

7951 AbN PAP bMEAK-LTh SHE 6ol20 

7Si>b TUBERCULIN TEil REACTION 66121 

7990 ASPHYXIA dbl22 

7991 KEbPiKATUKY PA1LLRE dbliO 
6C700 FRACTUKE Rib NCS-CLUSEO 6tol31 

60701 FkAUURt UNE H 16-CLOStU 66132 

60702 FRACTLRE TWL klbS-CLOSEU bo20 
bC7C3 FKACTCRt THRtE RlbS-CLOS b621 
bU704 FRACTURE FUUk RlbS-CLUSE b6221 
bC70i> FRACTLRE FlVt hIES-CLOSt 66229 
60706 FKACTCRt SIX hlbb-CLOSEU 66231 
6C707 FRACICRE SEVEN KIBS-CLOS 6b239 
6C70b FX t loHT/Muhc Mfc-CLOSED 67402 
60709 FX MULT RloS NLS-CLUSED 6?412 
6071C FRACTURE Rib NCS'UPtN yobO 

60711 FRACTLRt ONt K1B-UPEN 9340 

60712 FRACTURE THU R lb S-OPEN 93*1 

60713 FRACIURE THREE RlbS-OPEN 9346 
b0714 FRACTURE FLUR RIBS-OPEN 9349 
bC71t> FRACTURE FlVt RlbS-UPEN 9471 

60716 FRACTURE SIX RIBS-UPEN 9t»80 

60717 FRACTURE SEVtN RIBS-UPEN 9b6l 
60716 FX EIGHT/MURt K1BS-0PEN 9bB7 
60719 FX MULT RIBS NLS-OPEN 9973 
6072 FRACTURE OF STERNUM-CLUS 9991 



6073 FRACTURE OF ST ERNUM-OPEN 



English Description 
FLAIL CFEST 

UISLOCAT STERNUM-CLOSED 
DISLOCATION STERNUM-CPEN 
SFRAIN CF Rlbb 
SPRAIN CF STERNUM NLS 
SFRAIN 5 I ERNOCL A V 1CULAR 
SFRAIN CHONDRU ST ERNAL 
SFRAIN CF STERNUM NEC 
TRALM PR EUM01 HO RAX -CLOSE 
TRAUM PREUROTHORAX-UPEN 
TRALM H£ MO THORAX -CLOSED 
TRALM HE MO THORAX -OPEN 
TRAUM PREUMUHEMOTHOR-CL 
TRAUM PNEUMOHEMOlhUR-OPN 
LLNG INJURY NOS-CLOSED 
LLRG CLMUS10N-CL0SEC 
LLNG LACERATION-CLOSED 
LUNG INJURY NOS-OPEN 
LLNG CCMUSIUN-OPEN 
LURG L ACER AT ION -OPEN 
DIAPHRAGM INJURY-CLOSED 
DIAPHRAGM INJURY-OPEN 
BRONCHUS INJURY-CLuSEU 
1NTRATHCRACIC 1NJ NEC-CL 
BRCNCHU 5 INJURY-OPEN 
1 NT RATHIR AC 1NJ NEC-CPEN 
OPEN WOLNO OF TRACHEA 
OPEN WCLNO TRACHEA-CCMPL 
LATE EPF INT INJUR CHEST 
FOREIGN BODY IN TRAChEA 
FLRE1GN BODY BRONCHUS 
F E TRACF/BRONCH/LUNG NEC 
FB RESPIRATORY TREE NOb 
BURN LAW YNX/ TRACHEA/ LUNG 
AIR EMBCLISM 
F *T EMBCLISM 
TRAUM SLBCUTAN tMPHY SEMA 
SURG CCFPL1C-RESP1R SYST 
AIR EMBCL COMP MED CARE 



284 



Definitions of DRGs for Dinaiif and Disorders of the Respiratory System 
DUG IB. MDC 04P, Resection Procedures 



Operating Room Procedure 



Code CPHA Abbreviated English Description 



3229 DESTROY LOC LUNG LES NEC 

323 SEGMENTAL RESECTION OF LUNG 

324 LOBECTOMY OF LUNG 

325 COMPLETE PNEUMONECTOMY 



285 







CJ 


cj 


UJ 


























2> 














CJ 










UJ 


UJ 


CE 




UJ 




















_ 


0= 


CO 


CJ 






UJ ^ 




E LU 


E Z < 




o 


> 


4_ 


z 




iii 


2! 












UJ 










o 




UJ 


yj 


„ 


UJ E 


_» 


Z 


w O E 


J E 


z 


in 


CJ 






CD 


3 
















LJ 




z 


CJ 


o 


z 




UJ 


J D (5 


>J 




^ i-i LU 


3 


3 cn a. 


LU CJ 






-J 


UJ 


CJ 














= 






cn 










UJ 2 




E _J 


E 03 CJ 


¥~ ^ 


_i 


o a 


£ lj 


z 


co 


CJ 


O 


UJ 










_ 










Q 




_ 






J J 3 


03 


UJ D 


LU LU < 


03 E 




i i- 


E 








<J 


z 










UJ 




CJ 




cn 


CJ 










J 0. J 


M 


E H- 


E -J -J 


*~* UJ 


u. 


u a 


^ O Q. 


_J 




_ 










Q 






UJ 


^L 






<£ 




^ CC 








! -.« ! 


03 




Ll e 


o 


z o 


CD Q 






-J 




EE 






M 






Z 


;:• 


n 




2 




EC O 


(.~J 




3 U, U. 


X 


_j >-) 


> X X 






O Z _l 


e e cj 




E 






(=4 


CJ 


1- 


H 




< 




O 


(— 


Q 


a 


> z 


X X 




cn 


O □ 


LU 


-1 Ll 


l— O C9 


X X 


2 


e z> <. 


OO.H 


o 


UJ 


1- 


a 




UJ 


Z 


< 


D 


EE 


Z 


X 


□ 


UJ 


X 


a. «- 


a. h 


03 


< 


K 




< 


< < 


C9 CS 


□ 


Q J « 


•-i K 


> 


CJ 


03 




a. 


2 


<c 


O 


J 


UJ 


a 




cj 


x 


i- 


O !- 




€ 




03 Z Z 


_J 


2 CJ 


X E E 


< < 




I 


o x in 


t- tn 


« 


M 




UJ 




_l 






DL 






< 






O 03 


m LU 




Q 


lu □ a 


"t 




E X X 


E E 


01 


u. u. tj 


Q O 


en a. 




u. 


X 


2 


E 


a, 




Ll 


Q 


t- 


> 


OS 


Ll 




03 < 


a cc 


a 


LU 




E 


K CJ 


O a. e 


X X 




o o z 


o z 


< «t 






DC 






cn 




a 




< 




O 


a 


DC 


O « 


2> 


UJ 


X 




D 


03 < 


u. < < 


E E 


O 


o 


ZJO 


_! _l 


_l 


-J 


UJ 


_J 


< 


z 






-J 


CE 


a 


X 






Z Q 


U. Q 


X 




< <: 


LU 


LU E 


[ 1 1 1-« »— < 


< < 


« 


Z Z e 


3 < < 


E _J 


<s 


< 


cj 


< 


a. 




< 


LU 


< 


UJ 




1- 


z 


UJ 


m LU 


O LU 




i- 


t- u u 


J 


I O 


q a q 




UJ 


o a a 


_| M 


o a 






X 




UJ 


e 




EE 




e 


« 




c 


_J 


t- Z 


(J 


CJ 


u 


O «i « 


(3» 


U I 




a a 






x a 


U CJ 


X 


X 


_J 


X 


CE 


H 


X 




X 


Q 


DC 


z 




a. 


03 


> O 


a 


D 


D LL 1- 






03 LU UJ 




E 


01 CO E 


IT (J 


< 


o 


CJ 




u 






cj 


H 


cj 




a 


UJ 


cn 


cn 


< OC 


03 CC 


E 


E 


E M CC 


E 


E 


D 03 E 


LU E 






u z cs 


E O 


2 


" 




z 




CS 


z 


o 


z 




_l 


a. 




2 


HH LU 


a. cl 


a. 


t— 


H E O 


LU 


LU 03 


t- « D 


03 Li 




O U I 


I o z 


O IT 


a 




2 


□ 




1 


o 




o 


z 


a. 


Q 


CJ 


< 


a x 


□ 




CD 


03 < <J 


X 


X Q 


CJ CJ h 


O X 




Z Z h 


hC3 


I D 


at 










X 


CE 


D 


e 




X 


UJ 


2 


E 


UJ 1- 




X 


yj 


LU CJ UJ 


h- 


H- -1 


yjxD 


_l l- 


□ 


« « Q 


O a _J 


1- 03 


to 


E3 


«J 


09 


-1 


_J 


m 


a. 


B3 


_l 


UJ 


CC 




X 


- □ 


q a 


Q 


Q 


Q 03 Q 


O 


a o 


E UJ 03 


cj O 







« 


N CO t> 


«r o 




ry 


n 


s 


o 




rj 


n 


CD 


o 


rj 


n 






f g >o 


N CO 


a~ 










o n 


— r a 


n 


O O 




fa 


ru rii rj 


n n 


>T 






*t 




in 


t> 


o 


i> 


o 


o 


o 


tH 


CM 


ru cm 


ru ro 




n 


* o 


in 


in 


N N 


co co 


13 


ru n 


n 


n 


n n n 


n n 


n 


n 


n 


n 


n 


n 


n 


n 


n 


n 








f 


«r * 










«r 




a- «r 


«r * «r 




n n 


n 


n 


n n n 


n n 


n 


n 


n 


n 


n 


n 


n 


n 


n 


n 


n 


n 


n 


n 


n n 


n n 


n 


n 


n n 


n 


P3 


n n 


n n n 


n 







03 


Z 






















> 




CJ 03 


E CJ > 




03 


Z 03 Z 


Z 1- 






03 O 


o 








CJ 








> 






X 


> 


LU 111 CJ 


LU > LU X 


X 


Z LU Z 


QUO 


O CJ 






D X 




z 






X 








X 






o 


X 


Z _J < 03 E 


CJ X X □ 


Q 


□ X o 




~ D 






X > 


1- 


□ 




J 


X 








D 


> 




h- 


Q 


JOZ « 


< O 1- 




cr w a w 


(- 03 


H E 




ai 


> X 


< 


>— i 


O 


X, 










I- 


X 


> 


Cfi 


!~ 


< x JO < 


_l 1- 03 03 


i— 


« 03 < 1- 


< (J fH 


< »- 




c 


X H 


E 




uu 




CO 








CJ 


a 


X 


D 


cn 


U1Z JU»CCL 


03 a o 


CJ 


< 1- < 


E Z CJ 


U 01 




U 


H 


O 03 


< 


X 


E 


LU 








LU 


H 


c 


UJ 


o 


X > < 03 « LU 


_i o _i uj 


D 


E > x E 


UJ O x 








LL 


_l D 


(- 






-1 










CJ 


H 


X 


X 


O E LU < « < E 


< uj cj X 


E 


LU « Z UJ 


E E LU 


-1 CJ 




■o 


Ll Q 


E X 


03 Z 


X 


CO 




> 


> 


> 


X 


LU 


CJ 


u 


X 


< < O _| > E 


UJ X u 


{= 


E Q > E 


O 03 


E < 




at 


O 


x > 


3 < 


c 


c 


X 


X 


X 


X 


> 


CS 


X 


< 


CJ 


£ JZ JLULU J 


x u < < 


X 


E □ 


-1 


E 




+> 


03 Z 


LU X 


X _l 




X 


2 


Q 


o 


a 


a 


2 


ti 


E 


X 


1- > 1- E E < 


CJ < _l E 


X 


_J > < 


_l t- < 


a o 






> a z o 


1- 


> E 




X 


> 


l- 


h- 


h- 


X 


> 


2 


(- 


K 


CJ E 03 LU 


<tr jh 


D 


< E _l _J 


< CJ 


LU X 




■ r< 


cn z a « 


Q 


X 03 


X 




E 


U 


CJ 


o 


j 


E 


> 




N 


x D < > x O 


El-I- 


O 


UuJ\< 


111 JI 


-I H 




> 


E — 03 


_l Ll 


t- Z 


E 




X 


LU 


LU 


X 




X 


E 


_J 




Z E _J Ll X U. Z 


h- 01 E 


UJ 


X Z X LU 


X E CJ 


03 






a > 03 « 


LU O 


< 


UJ 


03 


-1 


X 


Q 


X 


H 


_J 


X 


X 


X 


>- H- O > 


IlhO 


E 


CJ CJ C5 


cj t- Z 


CJ 




t- 


« X - cj 




LL E 




> 




X 




E 


E 




-1 


2 


E 


E 03 E -J t— _l E 


U, O Ll, 




< _l < Z 


< in o 


< UJ 


ai 




CD O CJ X 


Ll Z 


O H 


o 


U 


H 


> 


h- 


□ 


X 


LU 




t— i 


UJ 


< UJ O < 03 < < 


o z 


_J 


E < E > 


E UJ E 


X 01 


(. 




1- x U 


O 








CJ 


e 




CJ 


X 


l_ 


J 




E 


JQ LU O LU -1 


LU <C O 


X 


h 111 H E 


h Q Q 


Lu 01 


3 


< 


03 CJ LU 


03 -h 


E 03 


L0 


X 


D 


X 


O 






X' 


X 


tn 




LU C9 O O 


LU E LU 1-1 


X 


O < 




01 « 


■a 




O LU -1 


3 03 




X 


Z 


E 


J 


_) 


X 


E 


_J 


CJ 




E 


cn _i e z z z e 


coin 


X 


cc z in J 


K JCC 


> Q 


at 


< 


Z X K < 


X 


< X 


X 


> 


t- 




o 


<u 


X 


E 






Lu 


i-> < D > > > LU 




CJ 


LU > « 


LU < LU 


X 


U 


X 


> > E (- 


> CJ 


E > 


> 


E 


cn 


X 




CJ 


X 


X 


5 


a 


X 


CJ CJ K E E E X 


t- a < > 


X 


X E 01 X 


X CJ X 


E Q 


o 


E 


X I < Q 


X z 


LU X 


X 


X 


UJ 


UJ 


E 


O 




o 


X 


UJ 


H 


z o n < < < k 


3 J CC LU 


e 


(-«>!- 


K O H 


X < 


(- 


CJ 


hl-tl- 


h- — 


E H 


h— 


-1 


Q 


X 


UJ 




□ 


u 


E 


2 


O 


~< _l 03 _l _l _l O 


CO CJ h- E 




O _l _l O 


□ _i □ 


LU E 



U 


« 


•c o - ru 


— CM 


n t 


o 




o 






ra 


0- 






01 




~ CD CD CD 






o 


o 


o 




ra 


IX 


ra 


n 




a. 


o 


N N N N 


rv n 




fx. 


o 


© 


o 


o 


c 


o 


o 


o 


a 


CJ 


o o o o 


o o 


o o 


o 


n 


n 


n 


n 


n 


n 


n 


n 



— — mn«TO^CMn*mo — mcDCh -« 

CMCMCim>0«0-0O-0f^NNr^NN0'l>0-0-O-HCM«0 

— ^-.-.^^njnifiifu 



286 



Oi 

c 



IB 

U 
01 
Q. 

o 



u 

CL 

in 
i) 
x 

(- 

0i 



CL 

o 

CJ 
Q 
X 



ru 



o 
x 

Q 



! C 
< O 

I -H 

















LU 








LU 




LU 




o 


CJ 




cn 




2_ 








CL 


LU 


L3 




L? 


ill ^ 

LU 


in h" 


UJ 


>■ 


UJ 


- 

r™ 


LJ 


LJ 




<l 








UJ 


^ 


L3 ^ 


cj « o 


z 


10 


— J 




^ 


r™ 


LJ 


CE 






LJ 


L3 


LJ 




uj o uj 








o 


LJ 


LJ 




LJ 


CL 


LJ 








LJ Q- 


x z h 




o 


UJ 


1 


LU 


LU 


r™ 


X 


LU 




h" 


LJ 


. 


2. 


?— cn 






z 


LU 


H~ 


h~ 


m 
UJ 




X 


. 


UJ 




r ft 
U J 




cn o 


u 


C3 


cj 


—r 


UJ 


U J 


LU 


■ 

i 




r ft 
UJ 


1 1 1 

UJ 


j 

i= 


1 1 1 
UJ 


rn 

UJ 


UJ UJ 






Q 


LJ 


LJ 


LJ 


J» 


1 1 1 

LU 


1 1 1 

LU 


UJ 




rn 

U i 


J— 


III T" 


ID O 


UJ 


UJ 




03 






lj 


O 


LJ 


T 
_L 


LJ 


1 1 1 

LU 


LJ 


T Ml 
J* UJ 


C3 < Q 


Z 


z 


UJ 




LU 


UJ 




z 


<t 


CJ 


| 


I 


I 


U J 


mum 


O 


o 


O 


UJ 


O 


O 


o 


I 


u 


1 


X 


U 


O 


1 UJ 


cn 3 


a 


a 


< 


o 


< 


< 


h" 


tj 




z 




t 


HI 


tn 


t- 






cj 


< 


U 










o 


IL 




o 


CL LU 


uj in uj 


UJ 


UJ 




cj 






l- 


X 


cn 








O 


o > 


O LU C5 


o 








r— 


K 


U. 


K 


UJ 




t- 


cn 


cr 




< X < 


< 


< 


cn 




CO 


l0 




o 


X 


< 


z 


< 


CL 


UJ 1- 


u u u 


cj 


cj 


UJ 


tn 


UJ 


LU 


X 


z 


o 


X 




_i 




Z U 








X 


UJ 


X 


X 


a 


_) 




t— » 




CJ 


X 


a < 




i- 


i- 


CJ 


X 


U 


a 






CE 


U. 




o 


Q 


Q O 


cn uj in 

UJ X UJ 


in 


in 




cj 






UJ 


LU 


UJ 




O 


LU 






LU 


uj 


u 




I 




z 


z 


I 


t- 


x 


1- 


X 


I Q 


I H X 


X 


X 


X 


X 




O 


o 


o 




z 


LU 


CD 


H 


K < 


u O u 


o 


cj 


UJ 


UJ 


o 




03 


a 


Q 




CE 


O 


O 


O CE 



UJ 
CE 

t- 

0) 

_J 
< 
UJ 
h- 

cn 
o 



o«^l^^^*-o^cDc^o^*lr)-o^cDc^ra-• 
fvr^Nr^Nr^Nr^r^CDQSoaQacDtBCDCDrijCD 



c 

o 
u 



o 
(- 
a. 

E 
o 
a 

CE 
OI 

c 



oi 

c 

LU 



LU 


O 


O 






cn 








LU 








EC 






















< 


a: (J 


< CJ 


> < 






z 




> 


CJ 


Q 


LU 






z 


CJ 


tn 


z 




l>s| 






cn 


Z 


CE 




< LU cj 


in LU 


Zh JO. <t 




in 


a 




tn 


LU 


□ 


a 








X 


o 


o 


1st 








o 


o 




z 


X Z UJ 


in z 


o z a. « cn > 


in 


o 


« 




CL 


z 


Z 


a 


LU 




CJ 


LU 


z 




« 


IL 






z 




< 


CE 


1 UJ z 


< 


>- < UJ CE ~ < 


z 




CJ 


a 






z 


Q 


LU 


r> 






t- 


_) 




t- 


CJ 




1- 


CL 


LU 


u z 


£ cj 


CJ CE h- CJ CJ 


LU 




< 


LU 




CJ 


J 




O 


a 


CE 


LU 


H 


<t 






CJ 


LU 


z 


< 


LU 


X 


1 < □ z > 


z 


u t- in x 


> z 


_i 


CE 


z 


a 


□ 


< 


> 


z 


o 


1- 


a 


CE 


-I 




O 




Z 


CE 


u 


LE 




i o. « o cn 


CJ •-< 


CE cj 3 1 UJ < 


□ 


a 


LU 






CE 


CJ 


LE 




z 


tn 


o 


O 




tn 




Q 




LU 


i— i 




LE 


1 t- <t « Q. 


< 


LU LU O Z 


CJ >-c 


CE 


CL 


z 




CL 




< 


> 






z 


< 


Z 




a 




CL 


X 


-I 


< 


I 


! < < CE 1- O 


> -I _l 


KUlt-M JUJ 


-i H- 


K 


O 


o 


u 




> 


X 


CE 


— J 


X 




t— i 


Z 


Ll 




CJ 


o 




0. 




CL 


1 EI J<>h 


r Q lu 


CE LU CJ _J Ul > 


CJ < 


Z 










CE 


X 


< 


< 


CL 


X 


CE 


< 




o 


i— i 




X 




Z 


< 


X UJ LU CE r Q 


o ce in 


< ce lu in 


< CE 


□ 


> 


t- 


CE 


<t 


UJ 


< 


-I 


z 


X 


CL 


LU 


CJ 


i- 




CJ 


t- 


CL 


CJ 


CE 


i— i 


1 CL CL J UJ O 


I- < CO 


o in > in iL 


CE UJ 


u 


a 


< 


(- 




CJ 


X 


_l 


*—* 


> 


X 


CL 




u 


o 


< 


U 


< 




LU 


a 


1 < O Q. Q. t- _J 


CJ CJ LU 


Z _J LU UJ O 


a cl 




□ 


CE 


tn 


a 






_f 


z> 


_l 


> 




t- 


o 


< 


CE 






i- 


X 


I 


1 « o o < 


UJ > 


LU LU CE CE > 


I O LU 


a 


LU 






CL 


H 




o 




-I 


CJ 


CJ 


Q 


CE 


O 


a 


a 


< 




X 


Q X U_ "-i 


•-■ t- 


in < z 




o 




CL 


CJ 


<J 


LU 


z 


X 


z 


CJ 




LU 






O 


I 




i 


X 


z 


t-H 


1 C5 O U Q Q 


o in cj 


u cn tn > o o 


> 


< 


CE 


O 


i— » 




LU 


»— 1 


< 




X 




tn 


Q 


CJ 


X 




u 


CL 


o 


CE 


< 


I (- < i— 1 CE CE 


CE UJ "-■ 


l-H LU LU M M 


LU CE X 


< 




i- 


1- 


a 








UJ 


< 


CO 






1- 






UJ 


< 


LU 


a. 


1 Z CE CE CJ < < 


< X O 


U > > U U h 


Q (- 


cc 


-J 


_1 


< 


< 




LU 


LU 


LU 




z 




CJ 


CJ 




LU 




CE 


CE 




LU 


I <Ih<OU 


u O 4 


< < < <. 


D Z 


LE 




LU 


i 


X 


tn 


tn 


tn 


tn 


_l 


o 


a 


< 


< 


UJ 




< 




I 


L0 


X 


1 _l Q. <t CE ►* <-« 




CE CE (E X CE CJ 


-J LU 


a 


CJ 


tn 


Cl 


CL 


»— 1 


M 




i— i 


CL 






CE 


LE 


tn 


< 


cr 


CE 


CL 


< 




1 Q. < CL O CE CE 


CE Z O 


O □ O O O « 


U 1 


r 


tn 


cn 


X 


X 


u 


u 


CJ 


u 


X 




a 


O 


o 


a 




a 


O 


< 


CE 


Q 


1 X -i LU X LU LU 


UJ CL X 


X X X X X _l 


CJ UJ 


LU 


< 


LU 


> 


> 


X 


X 


X 


X 




LU 


< 


I 


X 


_i 




X 


X 




< 


a 


1 i -1 Q CE H— CL CL 


CL O h 


h h (" h h 1 


O CE 


I 


> 


> 






LU 


LU 


LU 


LU 


cn 


CE 


LE 


r— 


1- 


c_> 


-J 






Q 


CL 


< 



mono 


cm «r 




m * oo 




Ch 




O 




nj 


n 




o 




ru 




ru 


n 


T 


O 


O 




ru 




CD CD O O 






cd in o 


CD 


o 






ru 


ru 


ru 


rj 


ru 


n 


m 




o 


>o 


-0 




CD 


CD 


CD 


r^- 


1- t t * 




r^r^CDODCOCDCDCDCD 


OD O Ch 


O 


o 


o 


o 


o 


o 


o 


o 


o 


o 


o 


o 


o 


o 


o 


o 


n 


n 


n 


n 


n n n n 


n n 




n o n 


n 


n 


T 


1- 


t 






t 


«s- 






<r 










in 


in 


m 


in 



287 



DRG 3D. MDC 04M, Asthma and Acute Bronchitis. Age 1b 



Principal Diagnosis 



Code 



CPHA Abbreviated English Description 



46410 

4641 1 

4660 

4661 

490 

49300 

49301 

49310 

4931 1 

49390 

49391 



AC TRACHEITIS NO ODSTRUC 
AC TRACHEITIS W OBSTRUCT 
ACUTE BRONCHITIS 
ACUTE BRONCHIOLITIS 
BRONCHITIS NOS 
EXT ASTHMA W/0 STAT ASTH 
EXT ASTHMA W STATUS ASTH 
INT ASTHMA W/0 STAT ASTH 
INT ASTHMA W STATUS ASTH 
ASTHMA W/0 STATUS ASTHM 
ASTHMA W STATUS ASTHMAT 



DRG AO, MDC 04M, 



Asthma and Acute Bronchitis, Age 16-49 



Principal Diagnosis 



Code 



CPHA Abbreviated English Description 



46410 

4641 1 

4660 

4661 

490 

49300 

49301 

49310 

49311 

49390 

49391 



AC TRACHEITIS NO OBSTRUC 
AC TRACHEITIS W OBSTRUCT 
ACUTE BRONCHITIS 
ACUTE BRONCHIOLITIS 
BRONCHITIS NOS 
EXT ASTHMA W/0 STAT ASTH 
EXT ASTHMA W STATUS ASTH 
INT ASTHMA W/0 STAT ASTH 
IN ASTHMA W STATUS ASTH 
ASTHMA W/0 STATUS ASTHM 
ASTHMA W STATUS ASTHMAT 



DRG 5B, MDC 04M, Asthma and Acute Bronchitis, Age 50-99, WiUmjijI C (. 



Principal Diagnosis 



Code CPHA Abbreviated English Description 



46410 AC TRACHEITIS NO OBSTRUC 

46411 AC TRACHEITIS W OBSTRUCT 

4660 ACUTE BRONCHITIS 

4661 ACUTE BRONCHIOLITIS 
490 BRONCHITIS NOS 

49300 EXT ASTHMA W/0 STAT ASTH 

49301 EXT ASTHMA W STATUS ASTH 

49310 INT ASTHMA W/0 STAT ASTH 

49311 IN ASTHMA W STATUS ASTH 

49390 ASTHMA W/0 STATUS ASTHM 

49391 ASTHMA W STATUS ASTHMAT 



DRG 6B, MDC 04M. Asthma and Acute Bronchitis, Age 50-99, And/Or C C 



Principal Diagnosis 



Code CPHA Abbreviated English Description 



46410 AC TRACHEITIS NO OBSTRUC 

46411 AC TRACHEITIS W OBSTRUCT 

4660 ACUTE BRONCHITIS 

4661 ACUTE BRONCHIOLITIS 
490 BRONCHITIS NOS 

49300 EXT ASTHMA W/0 STAT ASTH 

49301 EXT ASTHMA W STATUS ASTH 

49310 INT ASTHMA W/0 STAT ASTH 

49311 IN ASTHMA W STATUS ASTH 

49390 ASTHMA W/0 STATUS ASTHM 

49391 ASTHMA W STATUS ASTHMAT 



DRG 7B, MDC 04M, Pneumonia, Age 0-15 



Principal Diagnosis 



Code CPHA Abbreviated English Description 



4B00 ADENOVIRAL PNEUMONIA 

4801 RESP SYNCYT VIRAL PNEUM 

4802 PAR INFLUENZA VIRAL PNEUM 
480B VIRAL PNEUMONIA NEC 
4809 VIRAL PNEUMONIA NOS 

481 PNEUMOCOCCAL PNEUMONIA 

4820 K PNEUMONIAE PNEUMONIA 

4821 PSEUDOMINAL PNEUMONIA 

4822 H. INFLUENZAE PNEUMONIA 

4823 STREPTOCOCCAL PNEUMONIA 

4824 STAPHYLOCOCCAL PNEUMONIA 

4828 BACTERIAL PNEUMONIA NEC 

4829 DACTERIAL PENUMONI A NOS 
483 PNEUMONIA: ORGANISM NEC 
4841 PNEUM W CYTOMEG INCL DIS 
4843 PNEUMONIA IN WHOOP COUGH 

4845 PNEUMONIA IN ANTHRAX 

4846 PNEUM IN ASPERGILLOSIS 

4847 PNEUM IN OTH SYS MYCOSES 

4848 PNEUM IN INFECT DIS NEC 

485 BRONCOPNEUMONIA, ORG NOS 

486 PNEUMONIA. ORGANISM NOS 
4870 INFLUENZA WITH PNEUMONIA 

DRG 8D, MDC 04M, Pneumonia, Age 16-49, Without C C 



Principal Diagnosis 



Code CPHA Abbreviated English Description 



4800 ADENOVIRAL PNEUMONIA 

4801 RESP SYNCYT VIRAL PNEUM 

4802 PAR INFLUENZA VIRAL PNEUM 

4808 VIRAL PNEUMONIA NEC 

4809 VIRAL PNEUMONIA NOS 
481 PNEUMOCOCCAL PNEUMONIA 

4820 K. PNEUMONIAE PNEUMONIA 

4821 PSEUDOMINAL PNEUMONIA 

4822 H. INFLUENZAE PNEUMONIA 

4823 STREPTOCOCCAL PNEUMONIA 

4824 STAPHYLOCOCCAL PNEUMONIA 

4828 BACTERIAL PNEUMONIA NEC 

4829 BACTERIAL PENUMONIA NOS 
483 PNEUMONIA: ORGANISM NEC 
4841 PNEUM W CYTOMEG INCL DIS 
4843 PNEUMONIA IN WHOOP COUGH 

4845 PNEUMONIA IN ANTHRAX 

4846 PNEUM IN ASPERGILLOSIS 

4847 PNEUM IN OTH SYS MYCOSES 

4848 PNEUM IN INFECT DIS NEC 

485 BRONCOPNEUMONIA ORG NOS 

486 PNEUMONIA, ORGANISM NOS 
4870 INFLUENZA WITH PNEUMONIA 



DRG 9D. MDC 04M. Pneumonia. Age 50-150. And/Or 



Princ ipal 


Diagnosis 


Code 


CPHA Abbreviated English Description 


4800 


ADENOVIRAL PNEUMONIA 


4801 


RESP SYNCYT VIRAL PNEUM 


4802 


PAR INFLUENZA VIRAL PNEUM 


4808 


VIRAL PNEUMONIA NEC 


4809 


VIRAL PNEUMONIA NOS 


481 


PNEUMOCOCCAL PNEUMONIA 


4820 


K. PNEUMONIAE PNEUMONIA 


4821 


PSEUDOMINAL PNEUMONIA 


4822 


H INFLUENZAE PNEUMONIA 


4823 


STREPTOCOCCAL PNEUMONIA 


4824 


STAPHYLOCOCCAL PNEUMONIA 


4828 


BACTERIAL PNEUMONIA NEC 


4829 


BACTERIAL PENUMONI A NOS 


483 


PNEUMONIA: ORGANISM NEC 


4841 


PNEUM W CYTOMEG INCL DIS 


4843 


PNEUMONIA IN WHOOP COUGH 


4845 


PNEUMONIA IN ANTHRAX 


4846 


PNEUM IN ASPERGILLOSIS 


4847 


PNEUM IN OTH SYS MYCOSES 


4848 


PNEUM IN INFECT DIS NEC 


485 


BRONCOPNEUMONI A ORG NOS 


486 


PNEUMONIA. ORGANISM NOS 


4870 


INFLUENZA WITH PNEUMONIA 



DRG 10U. MDC 04M. Pneumonia. Age 50-150, Without C C 



Pr inc i pa 1 


Diagnos i s 


Code 


CPHA Abbreviated English Description 


4800 


ADENOVIRAL PNEUMONIA 


4801 


RESP SYNCYT VIRAL PNEUM 


4802 


PAR INFLUENZA VIRAL PNEUM 


4808 


VIRAL PNEUMONIA NEC 


4809 


VIRAL PNEUMONIA NOS 


481 


PNEUMOCOCCAL PNEUMONIA 


4820 


K. PNEUMONIAE PNEUMONIA 


4821 


PSEUDOMINAL PNEUMONIA 


4822 


H. INFLUENZAE PNEUMONIA 


4823 


STREPTOCOCCAL PNEUMONIA 


4824 


STAPHYLOCOCCAL PNEUMONIA 


4828 


BACTERIAL PNEUMONIA NEC 


4829 


BACTERIAL PENUMONI A NOS 


483 


PNEUMONIA: ORGANISM NEC 


4B41 


PNEUM W CYTOMEG INCL DIS 


4B43 


PNEUMONIA IN WHOOP COUGH 


4845 


PNEUMONIA IN ANTHRAX 


4846 


PNEUM IN ASPERGILLOSIS 


4847 


PNEUM IN OTH SYS MYCOSES 


4848 


PNEUM IN INFECT DIS NEC 


485 


BRONCOPNEUMONI A ORG NOS 


486 


PNEUMONIA. ORGANISM NOS 


4870 


INFLUENZA WITH PNEUMONIA 



DRG 11D. MDC 04M, Pneumonia, Aqe 50-150. And/Or C C 



Principal Diagnosis 



Code CPHA Abbreviated English Description 



4800 ADENOVIRAL PNEUMONIA 

4801 RESP SYNCYT VIRAL PNEUM 

4802 PAR INFLUENZA VIRAL PNEUM 

4808 VIRAL PNEUMONIA NEC 

4809 VIRAL PNEUMONIA NOS 
481 PNEUMOCOCCAL PNEUMONIA 

4820 K. PNEUMONIAE PNEUMONIA 

4821 PSEUDOMINAL PNEUMONIA 

4822 H INFLUENZAE PNEUMONIA 

4823 STREPTOCOCCAL PNEUMONIA 

4824 STAPHYLOCOCCAL PNEUMONIA 
4328 BACTERIAL PNEUMONIA NEC 
4829 BACTERIAL PENUMONI A NOS 
483 PNEUMONIA: ORGANISM NEC 
4841 PNEUM W CYTOMEG INCL DIS 
4843 PNEUMONIA IN WHOOP COUGH 

4845 PNEUMONIA IN ANTHRAX 

4846 PNEUM IN ASPERGILLOSIS 

4847 PNEUM IN OTH SYS MYCOSES 

4848 PNEUM IN INFECT DIS NEC 
485 BRONCOPNEUMONIA ORG NOS 
406 PNEUMONIA. ORGANISM NOS 
4870 INFLUENZA WITH PNEUMONIA 



DRG 12D. MDC 04M, Neoplasm 



Principal Diagnosis 



Code CPHA Abbreviated English Description 



1620 MALIGNANT NED TRACHEA 

1622 MALIG NEO MAIN BRONCHUS 

1623 MAL NEO UPPER LOBE LUNG 

1624 MAL NEO MIDDLE LOBE LUNG 

1625 MAL NEO LOWER LOBE LUNG 

1628 MAL NEO BRONCH/LUNG NEC 

1629 MAL NEO BRONCH/LUNG NOS 

1630 MAL NEO PARIETAL PLEURA 

1631 MAL NEO VISCERAL PLEURA 

1638 MALIG NEOPL PLEURA NEC 

1639 MALIG NEOPL PLEURA NOS 

1642 MAL NEO ANT MEDIASTINUM 

1643 MAL NEO POST MEDIASTINUM 

1648 MAL NEO MEDIASTINUM NEC 

1649 MAL NEO MEDIASTINUM NOS 

1658 MAL NEO THORAX /RESP NEC 

1659 MAL NEO RESP SYSTEM NOS 
1951 MALIGN NEOPL THORAX 

1970 SECONDARY MALIG NEO LUNG 

1971 SEC MAL NEO MEDIASTINUM 

1972 SECOND MALIG NEO PLEURA 

1973 SEC MALIG NEO RESP NEC 

2122 BENIGN NEO TRACHEA 

2123 BENIGN NEO BRONCHUS/LUNG 

2124 BENIGN NEOPLASM PLEURA 

2125 BENIGN NEO MEDIASTINUM 

2128 BENIGN NEO RESP SYS NEC 

2129 BENIGN NEO RESP SYS NOS 
2142 LIPOMA INTRATHORACIC 

2311 CA IN SITU TRACHEA 

2312 CA IN SITU BRONCHUS/LUNG 

2318 CA IN SITU RESP SYS NEC 

2319 CA IN SITU RESP SYS NOS 

2357 UNC BEHAV NEO LUNG 

2358 UNC BEHAV NEO PLEURA 

2359 UNC BEHAV NEO RESP NEC 
2391 RESPIRATORY NEOPLASM NOS 



DRG 130, MDC 04M. Neoplasm With Bronchoscopy 



Principal Diagnosis 



Code CPHA Abbreviated English Description 



1620 MALIGNANT NEO TRACHEA 

1622 MAL1G NEO MAIN BRONCHUS 

1623 MAL NEO UPPER LOBE LUNG 

1624 MAL NEO MIDDLE LOBE LUNG 

1625 MAL NEO LOWER LOBE LUNG 

1628 MAL NEO BRONCH/LUNG NEC 

1629 MAL NEO BRONCH/LUNG NOS 

1630 MAL NEO PARIETAL PLEURA 

1631 MAL NEO VISCERAL PLEURA 

1638 MALIG NEOPL PLEURA NEC 

1639 MALIG NEOPL PLEURA NOS 

1642 MAL NEO ANT MEDIASTINUM 

1643 MAL NEO POST MEDIASTINUM 

1648 MAL NEO MEDIASTINUM NEC 

1649 MAL NEO MEDIASTINUM NOS 

1658 MAL NEO THORAX/RESP NEC 

1659 MAL NEO RESP SYSTEM NOS 
1951 MALIGN NEOPL THORAX 

1970 SECONDARY MALIG NEO LUNG 

1971 SEC MAL NEO MEDIASTINUM 

1972 SECOND MALIG NEO PLEURA 

1973 SEC MALIG NEO RESP NEC 

2122 BENIGN NEO TRACHEA 

2123 BENIGN NEO BRONCHUS/LUNG 

2124 BENIGN NEOPLASM PLEURA 

2125 BENIGN NEO MEDIASTINUM 

2128 BENIGN NEO RESP SYS NEC 

2129 BENIGN NEO RESP SYS NOS 
2142 LIPOMA INTRATHORACIC 

2311 CA IN SITU TRACHEA 

2312 CA IN SITU BRONCHUS/LUNG 

2318 CA IN SITU RESP SYS NEC 

2319 CA IN SITU RESP SYS NOS 

2357 UNC BEHAV NEO LUNG 

2358 UNC BEHAV NEO PLEURA 

2359 UNC BEHAV NEO RESP NEC 
2391 RESPIRATORY NEOPLASM NOS 



Operating Room Procedure 



Code CPHA Abbreviated English Description 



3321 BRONCHOSCOPY THRU STOMA 

3322 FIBER-OPTIC BRONCHOSCOPY 

3323 OTHER BRONCHOSCOPY 

3324 ENDOSCOPIC BRONCHIAL BX 



DRO 14D, MDC 04M, Chronic Obstructive Pulmonary Disease Without C 



Principal Diagnosis 

Code CPHA Abbreviated English Description 

4910 SIMPLE CHR BRONCHITIS 

4911 MUCOPURUL CHR BRONCHITIS 

4912 OBSTRUCT CHR BRONCHITIS 

4918 CHRONIC BRONCHITIS NEC 

4919 CHRONIC BRONCHITIS NOS 
4928 EMPHYSEMA NEC 

496 CHR AIRWAY OBSTRUCTION NEC 

DRG 15B, MDC 04M. Chronic Obstructive Pulmonay Disease, And/Or C. C 



Principal Diagnosis 

Code CPHA Abbreviated English Description 

4910 SIMPLE CHR BRONCHITIS 

4911 MUCOPURUL CHR BRONCHITIS 

4912 OBSTRUCT CHR BRONCHITIS 

4918 CHRONIC BRONCHITIS NEC 

4919 CHRONIC BRONCHITIS NOS 
4928 EMPHYSEMA NEC 

496 CHR AIRWAY OBSTRUCTION NEC 

DRG 16B, MDC 04M, Spontaneous Pneumothorax 
Principal Diagnosis 

Code CPHA Abbreviated English Description 

5128 OTH SPONTANEOUS PNEUMOTHORAX 

DRG 17B. MDC 04M. Painful Respiration 

Principal Diagnosis 

Code CPHA Abbreviated English Description 

0741 EPIDEMIC PLEURODYNIA 

5110 PLEURISY W/0 EFFUSION OR TB 

78652 PAINFUL RESPIRATION 

9587 TRAUM SUBCUTANEOUS EMPHYSEMA 

DRG 18B, MDC 04M. Pulmonary Embolism, Without CO 

Principal Diagnosis 

Code CPHA Abbreviated English Description 

4151 PULMONARY EMBOLISM/ INFARCT 

9580 AIR EMBOLISM 

DRG 19B, MDC 04M, Pulmonary Embolism, And/Or CO 
Principal Diagnosis 

Code CPHA Abbreviated English Description 



1151 PULMONARY EMBOLISM/ INFARCT 

9580 MR EMBOLISM 



295 

419-177 O - 84 -- 20 



o 
c 

cn 
IB 



z 

o 

(j 
a 
z 



D 

o 
rg 

cs 
e 
a 









2 

r 






>: 


t- 




2 


Z 


X 




X 








2 




in 




z 


2 


Q 


K 


£2 


W 


U 


4 


:£ 


a 


o 


Q 


U) 






=: 


X 




1 CJ 


•I 


3 




a 




LU 


LU 


X 


z 








LU 




2 


2 


C 




I Ul 


X 




D 




□ 


1- 


E 


Ul 


3 


□ 


K 


□ 


t- 


U 


< 


2 






1 E 


UJ 




OE 














e 


J 


h- 




UJ 


X 




o 


c 


1 W 




4 


u 


_l 


cn 


X 


2 


O 


z 


CJ 


3 


10 


z 


EL 


LU 


r 


E 


u 


1 z 


3 


X 


p— 1 


3 




K 


3 


z 


< 










cn 




< 


u 




i 3 


Z 


uj 


SI 








1 


I 




^= 


1 




n 


2 


Q 








i i 


1 


I 


1 


1 


1 


1 


> 


> 




1 


> 


1 


1 


3 


2 


UJ 


£ 


«l 


1 K 


E 


s 


e 


E 


E 


E 




1- 


1 


>- 






r- 


1 


i 


i 


i 




1 4 


4 




^L 


4 


4 


4 






>* 










UJ 


f n 
y j 


rn 

UJ 


UJ 




1 _J 


_J 


=i 


-J 


-1 


_J 


_l 


> 


> 




s 


> 


> 


> 


3 


3 


3 


3 




1 3 3 


3 


3 


D 


3 


3 




4 




< 


< 


< 


< 


2 


2 


2 


2 


> 


i a 


Q 


Q 


Q 


Q 


Q 


Q 


u 


o 


> 


CJ 


(J 


O 


O 


o 


CJ 


u 


O 




1 o 


O 


O 


□ 


O 


C 


□ 
















2 


Z 


Z 


2 


c- 


1 z 


z 


2 


2 


2 


2 


2 


3 


3£ 


CJ 


3 


3 


3 


3 


a 


D 


C 


a 


J=> 






























K 


E 


E 


E 


XI 


1 O 


o 


C9 


CS 


CS 


CS 


CS 


O 


CS 


CS 


CS 


CJ 


O 


CS 


B9 


a 


£3 




4 


! Z 


z 


2 


Z 


2 


2 


Z 


2 


2 


2 


z 


2 


2 


z 












i 3 


3 


3 


3 


3 


3 


3 


3 




3 


3 


3 


3 


3 


U 


Ll 


Ll 


u. 


4 


i _i 


-1 


J 


_J 


_l 


_l 


-J 


_1. 


-1 




_) 


J 


-1 


J 


□ 


o 


a 


a. 


CL 


i a 


a 


a 


a 


a 


a 


Q 


cs 


o 


B 


03 


a 


a 


H 


S 


£2 


C3 


a 


CJ 


1 h- 


»- 


Ir- 




t- 


l- 




H 




H 


1- 


t- 




t- 


H 


I- 


K 





x O 

o 

o 

r- I— 

_l IR 

3 ~ 

cj I 

I l 

cn cn 

3 3 
X X 

cj cj 
Z Z 

o o 

E E 

cs cs 
U. Ll 

o o 



I— CJ 

in lu 
uj a. 
t- cn 
z 

X 3 
t- I 

cn 

1 « 
cn cn 

2) o 

X E 
U CS 

Z ~ 

O Ll 

E 

CS o 

z 

U 2> 
O _J 



z 

T Z 
< 3 
x 

ui r 
< 

O x 
Z Ui 

I I 
cn cn 

cn cn 
o o 

E E 

cs cs 



X X 
Q x Q 

a 
o o 

E t- t- 

_j cn 

« D -H 

Z O X 

1 I I 

cn cn cn 

cn cn cn 
o o o 

E E E 
CS CS CS 



cn o 
ui ui 

I— CL 

cn 
X z 
(- 3 

O I 

i cn 
cn -I 
■■h cn 
cn < 
a t- 
e o 

CS Ul 



z 

5C X 

z z a x 
< zj a 
x o 

Ul Z E K 

< CJ _J 

O x — D 
Z Ul Z cj 
I I I I 
l-l-l-l- 

cj cj cj u 
Ul Ul Ul Ul 



U U U U U U 2 

(J 

o cs o o o o z 
z z z z z z o 

2> 3 3 3 3 3 E 
I I I f I — I c=i 



X X 

cj cj 

z z 

o □ 

E E 

CS cs 



X X 

CJ CJ 

Z Z 

o o 

E E 

cs a 



X t- 

cn 
ui 

D I- 
t- 

cn x 

— K 

x o 

1 i 

h- H- 

CJ CJ 
Ul Ul 

X X 

U cj 

z z 
o o 

E E 

CS C5 



Z 

^ X 

z a x 

2 Q 
O 

Z E i- 

< CJ _! 
x « 2> 
Ul Z cj 



< < 



z z z z z 

o o o o o 

z z z z z 

u u u ui u 

z z z z z 

L 0. L L L 



CSCSCSCSCSCSCSC3CSCSCSCSCSCSCSCSCCS 



«««« rt ^,„ rjri , m oi ru rii rj n n n n n n n «* * * * * * "* io in m in m vi . m -c -o -o -o -. 



OOOOOOOOO OOOOOOOOOOOOOOOOOOOOOOOOOOOOOCO 





















Z 


X 




X 


K 






z 


X 




X 


I- 


































Z 


X 




X 


t- 




2 


s: 


a 


X 


a 


10 




2 




Q 


X 


a 


10 






Z 
















X 




X 


L- 


in 


z 


s£ 


Q 


X 


Q 


10 


CJ 


<£ 


2 




Q 




UJ 


CJ 


< 


z 




a 




LU 








X 




X 






2 


l£ 




X 


c 






cn U < 


2 




D 




UJ 


UJ 


X 


3 


a 




□ 




UJ 


X 


3 


O 




o 


|_ 




2 


z 


a 


X 


C 


cn 


(J 


< 


Z 








LU 




3 > Ul x 


3 


□ 




□ 




E 


UJ 




E 








E 


UJ 




E 




h- 




O 


<; 


3 




a 




Uj 


Ui 


X 


3 


G 




c 


1— 


Ol 


1- Z < E Ul 












cn 




2 


o 


_J 


in 


2 


10 




Z 


O 


_J 


cn 


2 


Ul 


X 




c 




□ 


t- 


E 






E 








c 


< o ~ cn cn 


2 


CJ 


J 


CD 


2 


2 


o 


X 




3 






2 


□ 


X 




3 






E 


Ui 


r 


on 


i- 






cn 




2 






rr 




Ul 


k i- z cn z □ 


X 




3 






3 


2 


Ui 


2 


CJ 


X 


O 


3 


2. 


Ul 


£ 


CJ 


X 


□ 


10 




< 


(J 


J 


in 


X 


z 


C 


X 












in CD ■ 3 Ul 3 z 


UJ 


2 


O 


X 


O 




1 


1 


1 


1 


1 


1 


1 


1 


1 


i 


1 


i 


1 


Z 


o 


X 




3 


i— 


1- 




Z 


U' 


2 








•o 


O H Z U 1 1 


1 


1 


1 


1 


1 


> 


> 


> 


> 


> 


> 


> 


CJ 


CJ 


CJ 


CJ 


o 


CJ 


CJ 


3 


z 


Ul 


z 


U 


2 


c 


T 






i 








01 


k ui 3 in x x 


3« 


X 


X 


X 


X 


in 


cn 


in 


in 


in 


in 


in 


UJ 


UJ 


UJ 


UJ 


UJ 


LU 


Ul 


1 


1 


1 


1 


1 


I 


1 


cr 


E 


E 


E 


E 


r*_ 






Z X H- Ul CS LU Ul 


UJ 


Ul 


UJ 


UJ 


UJ 






>— i 




e- 1 






z 


2 


z 


Z 


2 


Z 


Z 


in 


cn 


10 


10 


cn 


in 


cn 


















<u«z<jj 


_l 


_J 


_J 


_l 


-1 


E 


E 


E 


E 


E 


E 


E 
















O 


□ 


o 


c 


o 


c 


c 


-j 


_l 


— i 












_l < Ul E EE 


E 


a. 


E 


E 


E 


3 


3 


3 


3 


3 


2 


3 




03 


E5 


ra 


£3 


o 


CS 


Z 


z 


z 


z 


z 


z 


z 
















> 


E E 0- CS Z Z 


2 


2 


2 


2 


2 


UJ 


UJ 


Ul 


UJ 


UJ 


UJ 


UJ 


f- 


ir- 


t- 


ir- 


Ir- 


ir- 


K 
















u 




U 


U 


L- 


L> 






m i- (D < z o o 


O 


O 


□ 


O 


□ 


_J 


_J 


_l 


_J 


_J 


i 


-J 
















cs 




cs 


a 


cs 


cs 


cs 


i_ 






z 


^_ 






t- 


Z 3 _| D cj U 


(J 


CJ 


CJ 


U 


CJ 


E 


E 


CL 


E 


E 


E 


E 


cs 


CS 


CS 


CS 


CS 


CS 


C3 




1- 




i- 


D— 






















•4 O 05 _j _| 


























o 


O 


□ 


a 


a 


O 


□ 
































E K Ul cs es 




CS 


a 


m 


m 


CS 


ES 


03 


a 


CD 


CS 


Q 


E 


E 


E 


E 


E 


E 


E 


> 


> 


> 


> 


> 


> 


> 


c 








C 






< 


H > Z O 1- H- 








t- 


t- 


h- 








1- 


K 


t- 


E 


a. 


E 


E 


E 


E 


a. 


E 


E 


E 


E 


E 


E 


E 




^_ 


2 


z 




im 
















































< 


< 


< 


4 
2 


< 


< 


3 




D 


3 


2 








CS Ul UJ z CS z z 


2 


2 


Z 


2 


2 


2 


2 


2 


Z 


2 


2 


2 


2 


2 


r 


2 


2 


2 


2 


2 


2 


2 


2 


2 


Z 
















X 






































































E 


2I-X<ZEEEEEEEEEEEEEEEEEEEEE 


E 


E 


E 


E 


E 


E 


E 


C- 




CS 


cs 






c 


U 


_I<U10<EEEEEE 


E 


E 


E 


E 


E 


E 


E 


E 


E 


E 


CL 


E 


E 


E 


E 


E 


E 


E 


E 


E 


E 


E 




|— 


f— 


i— 


K 







cm o -« ru n «r in o o — • ru n c in «o o — ru n m < o — ru n t lo <i o — rv n <? u" < 

•0Oryri*OOOOOOO-«--«---'IBQJIIiDE(IiCDMMM k IKM>OOOOCCC 

rum — n>ooooooooocooooooooooocooooooo — — — 

>>>ooooooooooooooooooooooooooooooooocccc 



296 



a 


1 X 

1 Q x 


X 1- 

Q CD 














UJ 


UI 












cn 
















cn 




< 


< 












cn 


IK 


1 O 


UJ 














3 


3 












*— t 






cn 










o 


z 


t— * 














■«4 


1 O 


O K 














cs 


CS 








< 




cn 






*— i 










cj 


c 


z 


z 




cs 


cn 






D 


f-H 


1 X H 






z 










< 










*— < 




cn 






cn 


cn 


< 






> 


z 


□ 


o 




z 


i— » 






z 


SI 


1 U _i 


w i 






X 




X 




—J 


_l 


cn 






x 




3 






o 






< 




z 


3 


z 


z 




3 


H- 








C 


1 « 3 




r 


z 


o 


X 


a 


cn 


a. 


X 


□ 


< 




UJ 


cn 


y- 






u 


i- 


z 




cs 


o 


UJ 


3 


3 




-J 








a. 


UJ 


1 E CJ 

I 1 1 


X O O 


< 


3 




o 




UJ 






z 






1- 




x 


u 


cn 


> 




o 


z 


z 


D 


Z 


LU 


UJ 






z 






cn 


1 1 UJ 


X 




o 




o 


t- 


u 


z 




z 


X 


o 


cn 


UJ 


UJ 


a 


z 


z 


z 


o 


3 


»— i 


CL 


Z 


z 




_i 


o 






LU 


T3 


i Q a 


09 09 a. 


Ui 


z 


tr 


K 


t- 




i— t 


o 


UJ 


UJ 


< 


< 


cn 


a. 


z 


z 


□ 


□ 


3 


Z C5 


_) 


o 


cn 


a. 


a. 




3 


z 






tr 


01 


; 1- K 


i— t— cn 


< 


cj 


_l 


cn 


X 


z 


z 


3 




X 


a 


3 


<t 






z 


z 


UJ 


3 Z 












Z 


3 








*> 




z 


o 


X 


*-« 


3 






□ 




C9 


< 


X 


a 


t- 


cr 


X 


X 


CH 


3 


z 


Ul 3 


LL 


Q 


x 


Q 


cn 


cn 


< 


LLi 




cn 


a 


D 


1 _J -I 


_l _J 3 


z 


UJ 


z 


cj 


X 


o 


z 


UJ 


< 


_i 


1- 


o 


UJ 


< 


cs 


cs 


H 


UJ 


0. 


Z -1 


□ 




<£ 


Q 






tr 


z 






(- 




1 < < 


< < 1 


1 


1 


i 


1 


i 


1 




z 


_l 




z 


> 


x 




3 


3 


u 


Z 




a. 




CJ 


CJ 


a 


cn 


cn 


cs 


3. 




CO 




> 


1 UJ UJ 


UJ UJ CJ 


cj 


cj 




cj 


cj 


u 


UJ 


a. 


a. 




< 


z 






O 


o 




0. 


cn 


CL 


Cfl 


cj 






o 








cn 


o 




01 


1 1 1 


X X UJ 


UJ 


UJ 


UJ 


UJ 


UJ 


UJ 


z 












< 


« 


cj 


u 






UJ 


cn o 




o 


z 


z 


z 




CJ 


< 




1— 


CJ 


(- 


1 u CJ 


CJ CJ Z 


z 


z 


z 


z 


z 


2 


a. 


> 


u 


> 


> 


> 


_l 


J 






> 


<: 


.j 




tn 


o 


cn 


cn 


cn 


Z 


u 


Z 


cn 


in 


Ui 




1 < < 


< < 
















x 




GE 




x 


— j 


J 


o 


CS 


tr 


_j 


cn 


cn cn 


< 




< 


< 


< 




O 


cn 


□ 


> 


u 


XI 


i tr ac 


a: tr a 


09 


09 


09 


a 


C3 


S3 


> 


«£ 


z 


< 


< 


« 


UJ 


UJ 


z 


z 




_j 


< 


o — 




> 




_J 


_J 


z 




< 


a 




LL 




1 K t- 


t- t- K 


t— 


1— 


t- 


1- 






a 


a 


o 


Z 


2 


z 


K 


f- 




t— » 


z 


UJ 


UJ 


X _J 


a 


tr 


CL 


CL 




Q 


□ 


_) 




□ 


LU 




















<t 


z 


r 


□ 

z 


g 


o 


UJ 


Ul 


CL 


X 


O 




z 


i— 




< 


O 


O 


o 




z 


Q. 


o z 




< 


i -i -i 


_J _) 0. 


a. 


a. 


X 


CL 


X 


£L 


z 


□ 


3 


z 


z 


C3 


Q 


a 


o 


z 


l-H 


K 


~ X 


Q 


z 




K 


1- 


< 




O 


o 


3 


LL 


I 


1 o o 


o o cn 


cn 


cn 


CO 


cn 


cn 


CO 




cj 


UJ 


_J 




_J 


a: 


X 


□ 


□ 


_J 


cr 


cn 


z a. 


Z 


»— « 




cn 


cn 


tr 


X 


X 


tr 


UJ 




X 


i en cn 


in cn uj 


UJ 


UJ 


ID 


UJ 


UJ 


UJ 


x 


UJ 


z 


3 


3 




a 


□ 


X 


X 


3 




o 


tr > 


< 


cr 










u 


O 


< 


z 


< 


U 




•-.►no: 


ae 


DC 


IX 


X 


X 


X 


X 


cn 


a. 


a. 


a. 


a. 


S3 


e 


3 


3 


a. 


> 


0, 


□ cn 


cj 


0. 


X 


I 


X 


0. 


LU 


K 


on 


CL 


_l 



■o 

01 

3 
C 



C 

o 

CJ 



c 

0. 



in 
a> 
Q 



c 

Ul 



in 
p 

cr ca 

« UJ 

CL -1 

in e 

ui cn 

tr in »- 

3 CO 

cj o < 

z < cj 

UJ Z UJ 

O UJ « 

o cn x 

x > cj 

cj i z 

> a. c 

in z tr 

CL Ui c 



oooooooooo 



CD 


n 


T 


m 


hj 




o 


o 




CD 


o 






i—i 


o 




ru 


o 


o 


o 








n 


n 


n 


n 




(M 


in 


n 


cn 






ru 


"0 


ru 


rj 


n 


n 


n 


n 


n 


n 


lO 


m 


N 


0- 


o 


o 


o 


o 


o 


o 


o 


o 


o 


o 


o 


o 


O 


o 


O 


o 



>«■ o 



cn 


U0i 


in 






O 




o 


ru 




LD 


m 


tn 




rj 








ru 





«r no 

o m >c 
n n n ro 



-< o 

>C Tu «T 

O O O 

n <r 



























































Z 


X 




X 








X 




Z 


X 




X 


t- 




z 














Z 
























CJ 


Z 


a: 


a 


X 


c 


CO 




z 






z =c 


a 


X 


Q 


cn 


CJ 


< 


Z 










u 


< 


z 


















X 




LU 


< 


Z 








UJ 


U 


< 


z 




O < Z 




Q 




UJ 


LU 


X 




X 




X 




UJ 


X 




X 




X 


t- 










Q 




X 


X 


"S 


c 




c 




LL 


X 


1 x H- 


Ul x 3 


o 




O 


i- 


X 


UJ 


Z 


Q 


X 


Q 


cn 


X 


Ul 


z 


Q 


X 


Q 


in 




Z 










CO 


Ui 




X 


1- 






X 






i a in 


CL Ul 


tr 


t- 






cn 




3 




Q 




LU 


cn 




3 




O 




UJ 




aC 


X 




O 


K 


z 




z 


CJ 


_l 


in 


X 


tr 




z 


1 ui 


in z 


CJ 


_l 


cn 


X 


z 


o 




D 




O 


K 


z 


o 




O 




O 


i- 




Z Z 


a 


X 


O 


CO 


3 


o 


X 




3 




t- 


Z 




X 


1 o K 


z O x 




3 




t— 


3 


z 


Z 


X 




t- 




3 


z 


Z 


X 




1- 




CJ 


< 3 




Q 


_J 


Ul 


1 


z 


Ul 


Z 


CJ 




c 


z 




i »- 


3 Z Ul 


z 


CJ 


I 


o 


1 


1 


< 


CJ 


_l 


cn 


I 


1 


1 


< 


CJ 


_l 


cn 


X 


Ul 


X 


o 




o 


»- 


cn 


1 


1 


1 


1 


i 


1 






T 


i tn x 


1 1 1 


1 


1 


1 


1 


CJ 


CJ 


X 




3 




H 


cn 


cn 


X 


<— i 


3 


»— i 


h- 


X 


Ul Z 


X 


1- 


t- 




LU 


Ui 


Lu 


LU 


U 


LU 


UJ 




ca 




i t- 


XXX 


X 


X 


X 


X 


LU 


Ul 


LU 


z 


CJ 


X 


O 


o 


o 


Ul 


Z 


CJ 


I 


O 


cn 


< 


O 


_! 


cn 


X 


Q 


Q 


Q 


Q 


c 


c 




1— 




f- 


1 x o 


< < < 


<t 


< 


< 


«£ 


Z 


z 


1 


1 


1 


i 


1 


z 


z 


1 


1 


1 


i 


1 


z 


O x 




3 






O 


c 


O 


□ 


o 


□ 


c 








i i i 


tr ir tr 


tr 


X 


X 


X 






CJ 


o 


CJ 


u 


CJ 






cn 


in 


cn 


cn 


cn 


3 


Z Ul 

i 1 


z 


CJ 


i 


□ 


Z 


z 


Z 


Z 


z 




z 




_l 


_l 


i < < 


o o o 


o 


O 


o 


O 


ca 


ca 


LU 


UJ 


LU 


LU 


LU 


ca 


ca 


□ 


o 


D 


o 


□ 


1 




1 


i 


1 


















< 


< 


j U-H l-H 


XIX 


X 


X 


X 


X 


i- 




Z 


z 


Z 


z 


Z 






z 


z 


z 


z 


z 


> 


> > 


> 


> 


> 


> 


CJ 


CJ 


CJ 


o 


(J 


U 


CJ 


u 




u. 


1 z z 


1- h h 


t— 




(- 


t- 






























cn 


in in 


cn 


cn 


'in 


CO 
















I 


x 




1 o o 


O O O 


o 


o 


o 


o 


> 


> 


ca 


ca 


o 


ca 


ca 


> 


> 


ca 


ca 


ca 


ca 


ca 




t— < «— « 






i — i 




CJ 


(J 


U 


CJ 


CJ 


CJ 


CJ 


CJ 






1 z z 


z z z 


z 


z 


z 


z 


X 


X 


t- 


1- 


K 


t- 


t— 


X 


X 


i- 


t- 


i- 


H 


*- 


X 


X X 


X 


q: 


X 


X 


< 


< 


< 


< 


< 


< 


< 


c 


< 


< 


1 3 3 


3 3 3 


3 


3 


3 


3 


< 


< 












< 


< 












3 


3 3 


3 


3 


3 


3 


X 


X 


X 


X 


X 


X 


X 


X 




X 


1 Ul Ul 


Ul Ul Ul 


u 


LU 


cu 


LU 


z 


z 


z 


z 


Z 


z 


Z 


z 


z 


z 


Z 


Z 


Z 


z 


LU 


LU LU 


LU 


LU 


CU 


LU 


o 


o 


□ 


o 


□ 


o 


g 






I- 


1 Z Z 


z z z 


z 


Z 


z 


Z 


o 


o 


o 


□ 


o 


o 


o 


o 


o 


D 


o 


o 


O 


o 


_l 


_l _J 


_) 


_J 


_J 


_l 


X 


I 


X 


X 


X 


X 










1 CL CL 


CL CL CL 


CL 


CL 


X 


X 


z 


z 


z 


z 


z 


z 


z 


z 


z 


Z 


z 


z 


z 


z 


X 


X X 


X 


X 


X 


X 


t- 


H 


t- 


1- 




1- 


r— 




5 


_l 














_l 


_J 


_J 


_] 




—I 


_J 


_J 


1 


i 


—1 




_J 


_J 




























5 




I 03 03 


ca ca ra 


ca 


ca 


£3 


CQ 


3 


3 


3 


3 


5 


3 


3 


3 


3 


3 


3 


5 


3 


3 


ca 


m ca 


cn 


m 


ca 


ca 


ca 


E9 


C3 


ca 


B 


Ci 




cn 


CO 


CO 


1 H 1- 


i — i — »— 


t- 






»- 


X 


a. 


X 


X 


X 


X 


X 


X 


X 


0- 


0- 


X 


X 


X 




1- K 


t- 






K 


1- 




t- 








I— 











in<io-*run*j-m«oo-< 


ru 


n 


T 


m 


■0 


o 




ru 


n 




m 


~o 


o 






n 




in 


-0 


o 


-> ru 


n 




m 


>o o 




"u 


01 


i o<irvtvr-i^rvr^rvcoco 


CO 


CD 


CD 


CO 


00 


o 




o 


o 




cv 


o- 


o 


o 


o 


o 


o 


o 


o 












- ru 


ru 


ru 






























rj 


ra 


ru 


ro 


ru 


ru 


ru 


ru 


rii rj 


ru 


ru 


ru 


ru nj 


r u 


re 


o 

CJ 


I ooooooooooo 


o 


o 


O 


O 


o 


o 


o 


o 


o 


o 


o 


o 


o 


o 


o 


o 


o 


o 


o 


o 


o o 


o 


o 


o 


Q o 


o 


C 



297 



X 




CJ 


tn 
















cn 


UJ 


o 




L0 
















z 




(— . 


tn 






<s 


_J 
















z 


z 


u 


*— < 


> 


> 






Q 




UJ 


UJ 


or 


_J 


X 


X 


<C 


C5 






tn 


tn 


CJ 


r- » 
LJ 










at. 


III 








CC 


<« 


< 


z 


G 




tn 


X 


X 


2 


UJ 


a. 


EL 


o 


_l 


O 


CL 


CL 


CL 




> 


o 


O 


r 






< 


z 


z 


S 






z 


g 


cn 


z 


_j 


UJ 


Ui 


4 


< 


D 


o 


UJ 






_j 






_J 




£ 


z 


z 


tn 




o 


_l 


> 


Q 


tn 


G 




a. 


o 


> 


CJ 


< 


or 


or 


□ 


LU 


UJ 




CC 


-J 






o 


u 


CC 


Z 


z 


o 


UJ 


□ 


> 




K 


> 


Q 


a. 


a. 




_J 


G 


tr 


M 


< 


_J 








H 


u 


z 


< 


t- 


tn 


< 


U 




_J 


< 


tn 




z 


tn 


z 






a 


c 


Z 






o 


cc 


UJ 


E 


□ 


Lu 






H 


C5 


z 


Uj 


CL 


_J 




> 


> 


UJ 


tn 


z 


_J 




Z 


G 


Q 




_J 


X 


> 




g 


Z 


o 


0. 


>■■< 


< 


'€ 


a. 


tn 


_l 


a, 




u 

















































cc 






ill 

tn 


2 


Q 
















































•c 






G 


Ui 


UJ 












,_J 


tn 


Z 
















CL 


Z 












_ 

tn 




—J 




~ 


CL 


tn 


tn 


UJ 


UJ 


Q 


tn 


cj 


□ 


UJ 






2. 








_ 


D 


UJ 


tn 


_ 


UJ 






LJ 


-J 




LU 


CJ 


LJ 


LJ 


□ 


tn 


CO 


UJ 


□ 


1 


—i 


CL 






UJ 


z 


2r 




UJ 


1 


CL 


G 


UI 


G 


LU 




—j 

Z. 








I 


1 


— i 




o 


□ 


tn 


j 


tn 


<_) 


n 








UJ 


UJ 


z 


o 


tn 


o 




o. 


_j 


CL 








CC 




X 


X 


<_) 


u 


_j 


_J 


o 


u 


09 


i 


I 


z 


UJ 


o 


CL 


CL 


UJ 


□ 


co 


1 


u 


o 


cj 


O 




z 


> 


UJ 


z 


< 


< 


i 


i 


o 


cj 


_i 


1 


M 


tn 


tn 


UJ 


CL 


1 


Q 


c 


CL 


1 




tn 


1 


i 


1 


1 




G 


< 


►— 


G 


cr 


cc 


X 


tn 


1 


1 


cj 


tn 


CC 


o 


□ 


CL 


□ 


in 


1 


1 


o 


tn 


cc 


o 


Z 


z 


z 


z 




Z 


_l 


tn 


Z 


D 


g 


< 


ca 


tn 


CO 


l 


a 




z 


z 


o 


1 


m 


tn 


en 


1 


ca 




z 


G 


D 


G 


G 


tn 


cc 


u 


o 


CC 


I 


cc 




m 


CO 


tn 




UJ 






1 


tn 




Q 


ca 


tn 




UI 




Z 


Z 


or 


CC 


a 


UJ 


o 


cc 


UJ 


K 




o 


or 




t— 1 


ca 


CC 


cc 


tn 


tn 


B 


m 


cc 








cc 


cc 


tn 


CC 


cc 


UJ 


LU 




H 


z 


c 


K 


□ 


o 


X 




cc 


DC 


» 




o 


ca 


D 




t« 




K 


cc 






HO 


ca 


UJ 


UI 


1- K 


(- 


CC 


tn 


cc 


z 


tn 


z 


z 


K 


UJ 






cc 


z 


r 






CC 


cc 


UJ 






cc 


Z 


i— < 


K 


r- 


tn tn 


tn 






UJ 


g 




G 


G 


o 


UJ 


cc 


Ui 




UJ 


n. 


cc 


CC 






UJ 


or 


UJ 




UJ 




cc 


tn 


tn 


UI 




Ll 


u 


1— 




u 


UJ 


u 


z 


cc 


G 


> 


X 


> 


t- 






UJ 


□ 


cc 


G 


> 


X 


> 










X K 




O 


o 


tn 


o 


o 


Z 


z 


u 


X 


□ 


1— t 


t— « 


UI 


X 




H- 


z 


3 


X 


G 




>— ■ 


UJ 


X 


H- 


u. 


Ll 


CJ < 


< 












0. 


CL 


X 




U 


u 


tn 


tn 


C5 


_l 


_l 


□ 


t- 




U. 


LL 


tn 


tn 


C5 


_l 


o 


O 


CJ 


u 


Z 


z 


z 


z 


z 




















G 


3 


















g 






_J o 


O 












z 


z 


z 


u 


cj 


cj 


cj 


CJ 


UJ 


Z 


Z 


CJ 


CJ 


o 


CJ 


CJ 


cj 




UJ 


z 


CJ 


u 


-1 _l 


_J 


< 


< 


< 


< 


< 


G 


G 


G 


< 


< 


< 


< 


< 








< 


< 


< 


< 


< 


< 


< 






< 


< 


< tn 


to 


CC 


cc 


CC 


cc 


cc 


< 


< 


< 


cc 


cc 


cc 


cc 


cc 


X 


X 


X 


cc 


CC 


cc 


CC 


CC 


cc 


cc 


X 


X 


cc 


cc 


_i — 




0. 


CL 


CL 


CL 


CL 


CC 


CC 


CC 


U. 


u 


u 


U 


U 


U. 


Ll 


U 


u 


U- 


u 


u 


LL 


Ll 


u. 


LL 


U. 


Ll 


Ll 


Ll Q 


Q 


tn 


tn 


IS! 


tn 


IP- 


K 


r— 







n 


CD 


o 








O 




rd 


•0 






-0 




N 




CD 


CD 


CD 






— ' 
















in 


m 


in 


in 


in 


in 


in 


in 


m 





n 


«r 


in 


o 


IN 


CD 


t> 


O 




Cil 


n 




m 


O 


IN 


CD 


o 














O 






t> 






fil 


o 


o 


o 


o 


o 


O 


o 






















ru 


n 




-0 




n 










o 




rv 




IN 


IN 




r-- 


|N 


|N 


C- 


N 




IN 


fN 


|N 


N 




IN 


IN 


|N 


rN 


t> 


o 


CD 


CC 


CO 


CO 


CD 


o 


O 


o 


o 


o 


o 


o 


O 


o 





o 


o 


O 


o 


o 


o 


o 


O 


o 


o 


o 


c 


O 


n 


n 






«*■ 


<r 




■J3 


-0 


-c 


CD 


CD 


CO 


CD 


CD 


CD 


CD 


CD 


03 


CO 


CD 


CD 


CD 


CO 


CD 


CD 


CD 


CD 


CD 


CD 


CD 


OD 


CD 


CO 


CO 


CO 


CO 


CD 


CD 


CD 











NG 














CJ 










2 


CJ 










G 




CJ 


tn 








UI 






z 


< 


< 


UJ 








CJJ 






UJ 


O 








z 


U 




G 


Z 


_l 


2 








2 




Z 


2 


z 










UJ 




Z 


LU 


LL 










3 




c 










u 


2 


z 




G 


Q 


2 


Q 


£9 






-1 


tn 


z 


r 


z 






UJ 


O 






UJ 


UJ 






Z 








or 


G 


G 


G 


o 




2 


u 


> 


cn 


z 






O 


G 




z 




UI 


UJ 


UJ 


UJ 


z 






O 


X 


□ 


CL 


z 


CL 


u 


_l 




G 


tn 


0. 


£ 




z 


G 




2 


z 




2 


*N 


_l 


cn 








-J 


cr 


0. 




CL 


CL 


-J 




O 


G 


< 




(J 


G 


UJ 


0. 








UJ 






N. 


\ 






u 


UJ 


EL 


tn 


z 


CL 


or 


tn 


o tn 






a£ 


cc 




_J 








□ 


z 


O 




c 






UI 


Z or 




tn 


or 


H 


Z 


D 


□ 


tn 






CL 


z 


tn 


or 


CJ 


0. 


or 


G UI 




E 


Q 


10 


o 


UI 


UJ 


or 




G 




D 


Q 


n 


< 


G 




_i tn -> 




LU 




1 




> 


> 


UJ 


tn 


U 




Z 










u 


l-H u 


LO 


2C 




aC 


1- 


_l 


J 


s£ 




Z 


tn 


G 


2 


E 


cc 


or 


<£ 


- tn z 




CC 


Z 


or 


< 


< 


< 


E 


tn 


CL 


G 


UJ 


O 




o 


o 




tn o < 


tn 


□ 


o 


< 


_l 






Q 


o 




Q 


2 


CJ 


CL 


CL 


0. 


a 


or tn u. 


D 




o 


a 




o 


o 


X 




< 




0. 




< 


< 


< 


< 


ui tn i 


K 




s 




1- 


cc 


cc 




tn 


(J 


O 






> 


> 


> 


> 


z < a 


UJ 




"Z 


-1 


z 


UJ 


UJ 


_J 


UJ 




K 




• 


N. 




N, 


N. 


or cs or 


ca 


-1 


tn 


0. 


UJ 


_J 


_! 


< 


£= 


-1 


o 


L0 


UJ 


Z 


z 


z 


Z 


< < M 


G 


< 


G 


■z 


> 




_! 


o 


tn 




z 


G 


Z 


G 


G 


G 


G 


Ll m ca 


tn 


z 


Z 


2 




< 


S 


CJ 


< 


tn 


{—1 


Q 


CL 


Ll 


u 


u. 


U, 

















CJ 


tn 








ca 












in 


to 




a 


cn 




tn 


u 




< 


UJ 


□ 






ca 


\- 




X 






cn 






ir 


z 


o 


tn 




LU 


< 




z 


z 












< 




Z 




cn 


K 




o 


2 




H- 


2 




C 






< 






t- 




cr 




G 


in 


c 


O 




cj 




1- 






P 


<: 


<r- 




_i 


< 




O 


tn 


o 




Z 


< 


cc 


z 


6 




a 


i 


2 


»- 


< 


or 


Z 


Z 


G 




□ 


z 


□ 


X 








Q 




CL 


a. 


2 


Z 


; " 




or 




UI 


U 1 




G 


z 




z 


1- 






Ln 








m 


O 


□ 


2 


2 






C9 


o 


tn 






CJ 




o 




in 








c 


UJ 


CJ 


z 


G 


a 


K 




< 


< 




tn 


tn 


UI 


z 


z 




<: 


CL 




c 




or 




G 


UI 


z 


N. 


a 






u 




G 


z 


□ 


G 


cs 




> 


z 


cr 


tn 




CL 


UJ 


Z 


G 


Q 










u 


U 






UJ 


z 


Q 


I 




CL 


c 


or 


cn 


z 


0. 


LU 




LL 


X 


X 


X 




u 


cn 


tn 


z 


G 


Ui 


N. 






z 


X 


LU 


0. 




2 


Ll 




UJ 


UI 


1- 


o 


Ui 


G 


G 


c 


_i 


Z 


t— 


c 


or 


Lu 


CJ 


or 




UJ 


0. 




z 








^. 


N. 


u 


u 








in 




< 


I 






»- 


CJ 




Z 


< 










CC 


u 


u 


tn 


U 


u 


u 


z 






or 


or 




Z 


O 


< 


z 


Q 


Q 






G 


Ui 


UI 


z 


o 


c 


e 


< 


5 


z 


O 


o 


z 


UJ 




z 




2 


z 


< 


< 


UJ 






UI 






z 




LU 


5 


CL 


CL 


o 


tn 


-1 




_i 


□ 


O 


Z 


Z 


_J 


-1 


-I 


H 


in 


tn 


G 


u 




< 


< 


> 


tn 


\ 


_l 


G 


CJ 


u 


UI 


UJ 


CL 


< 


< 




tn 


L0 


U 




_J 


c_ 


> 


> 


N, 


UJ 


o 


G 


CL 






> 


> 




or 




h- 


UI 


Ui 






< 




N, 


N. 


Q 


N 




CL 




CL 


CL 


X 


X 


t- 


G 


G 


z 


CJ 


CJ 


z 






c 


Z 


Z 


□ 


_J 


_l 




or 


tn 


cn 


CL 


CL 


CJ 


U! 


U 


G 


cn 


tn 




Ln 


1 




G 


G 


□ 




o 


CJ 


X 


UJ 


UI 


r 


z 


< 


_J 


_J 


CL 


a 


ca 




G 


G 


a 


U 


Ll 


U. 


o 


tn 


<E 


CJ 


or 


or 


UJ 


UJ 


ca 


CL 


CL 


in 


< 


< 


CL 


X 


CL 





o 




ru 


n 




m 


-0 


IN 


CO 


o 














o 




m 


n 


«t 




o 




CB 


o 




CO 




o 


0" 




00 




o 


o — 


in 


m 


m 


in 


m 


m 


in 


m 


m 


m 


o 


— i 


rg 


n 


^ > 


in 


■0 


•a 


•o 


-0 




o 






fN 


CD 


CO 


CD 


© 


o 


o 








ru 


n n 


L> 


o 


o 


o 


t> 


t> 




Ch 


o 


Ch 


o 


o 


o 


G 


o 


o 


o 


o 


o 


o 


c 


o 


O 


o 


o 


O 


o 


o 


o 




















>* 




«r 






■a- 


«t 




in 


m 


m 


m 


m 


m 


m 


m 


m 


in 


ID 


in 


in 


in 


in 


in 


m 


m 


in 


m 


m 


m 


in 




in 


m jn 













ST 




























UJ 






















1 1 tn 7 






X 










LJ 




LJ 






rh 

U> 


UJ O QC 


A. UJ 


CJ 


(J 






UJ 


=1 


— s 
—J 


LL) 








•y 
<b 


f n 7 7 

UJ 4L UJ 


o o 


1 1 1 
UJ 




cn 






LU 


h~ 




. 










< z 


Z 


z 


Q 








UJ 










1 


rn *w s» r n 
UJ ^ ^ UJ 

^ -J -J 


tr cn 
x cc z 


Z 




UN 




Q- 

X 




- - 


r ft 
UJ 


LU 






. 


^ ^ ^ u 


a. lu cc 


or 


a. 


o 










X 








iii mi rn 
yj w tji yj 


f i n r r r r 7 

W W 2- 2. 1- X 


< o o z 


O 


z 


cn 




rn 
UJ 


X 


— > 


H" 






t w 


fn u 7 n 
UJ r" *. u 


iii iii n n ^ "'i 

Ul LU U U J J H 


« z Z o 


z 


Z D 








-J 




L—l 


, 




1 


x ffi 7 


7 7 7 i— 

& £ <d r - * 


o h n m 


CD 


D _) 


h- 




L_ 


■ 




i 
i 


UJ 




D 


LU > _l 


I < < « « cn 


u. < t- 


< 


K~ 1 


cn 




cn 


i 


> 


cc 


m 




_1 


in (j > 


o > > z n 


u. < 




D cn 


UJ 




Ul 


cn 


tr 


< 








« U. _l 


z _l > > < « — 


OlL>J 


> 


a, cn 


X 




X 


o 


< 


UJ 






1 ° 


O JO< 


o < tr tr o rx cc 


O C£ « 


CC 


cn cn < 


u 






z 


z 


z 


z 




1 M 


< r 


CC Z O O x < | 


cn ok< 


o 


- z 










o 


cn 






o 


in »- in o 


BOhhUUl 


Ul O h Z LU h 


tn _j i 


-J 


X 


cn 


Q 


r 




_J 


< 






z <t < o 


-> Z < UJ Z 


c cc 


> < o 


< 


o 


> 


Z 


_j 


a. 








uj z cn < 


z < tr cc tn to z 


_i « tr > cc 


CC O 


H Z Z 


z 




cn 


< 




< 


u 


X 


Z 


Nl UJ UJ 


uj n d < 


< CD « CC O 


h Q I 0. E J 


cc 


o 




u. 


Q. 




cc 


> 




K O Z O 


C!> Ci 0. tL t- H 


IOLUIILh 


C9 O □ _1 


o 


(J 


a. 








UJ 


X 


111 


UJ Z UJ z 


zzinmuux 


ODcna-KcncrDZZUj 


z 


o 


cn 


z 


Z 


z 


E 


a. 


X 


« O O O 


O D UJ LU LU UJ r 


ZJLUXCUJI-OIJJD3 


a 




UJ 




G3 


a 


D 


cn 


CC 


K U « _l 


u _J cr cc a. a. o 


<ua:IOiriouI<(l) 


<t 


X 


cc 


< 


< 


< 




< 



T3 

3 
C 



C 
O 

u 



o 
c 

cr. 
•0 

Q 



o — o- — m o«r«jch 
m^*in«o«o«octi^CDCDn«oinoooo-'riin«T>ONODi>--rii-«ir)o 

^nQCDCDCQCQCDffi^9^^^<}<0-£l>0>0<0<0>0<l<i'4j<Or , jQ'inu^l> 

«n*v***v*u^inininG3CDa3CDCDCtiCDa:cDCDCtia3CDC^ 



_i a. 

O 

1 I 
cc cc 

o 

1 X 



a 

Ul o 

cn ui 

o cn 

_i o 



o o 
z z 

Ul Ul 
X X 

X o o 
I- z z 
ODD 
Z UJ Ul 
Ul z z 

X CL CL 

z z z 

D D D 
< < <t 
CC CC CC 



> cn 
cc z> 

"5 Z 

z o 

u 

o o 
z z 



Q 

Ul 

cn z 

O Ul 
_) CL 

u a 
i i 
z tn 
o o 

-! Z 

<t > 
CC CC 

UJ o 

U "5 

< z 
_l « 

o cs 
z z 

D Z> 
_J 



Z 

Z UJ 

Ul CL 

a o 

I 

1 Z 
z o 

o •-■ 
<-> t- 
tn < 

D OC 
H ui 
Z O 
o <. 

«J _J 

O C!> 

z z 

3 D 



o 

Ul 

tn z 

O Ui 

_i a, 
u o 
i i 
> > 
cc cc 

z z 



z z 

< < 
CC CC 
X X 
CL CL 

< < 



_l _l _J O Q 



Q U 

Ul I 

cn u 

O Ul 
-I z 
u 

I -) 
> z 
tr *-> 
z> 

"5 O 
Z - 

< 

tn tr 

D O 
X X 

u t- 

Z cc 

o i- 

cc z 

Q •-• 



z 

UJ 

a. 

o 
z i 
ui u 

CL LU 

o z 

I 

> -) 

cc Z 
D - 

-> 

Z U 

cc 

tn o 

D X 
X K 
U < 
Z tr 

O K 
CC Z 
CO -> 



_J 
a. 
z 
o 

u 
i 

< < 

UJ UJ 

I X 

o u 

< < 
tr. tr 



tn < 

UJ Ul 
X X 

u u 
< 
tr tr 

D t- 
"5 

z z 



u. u. 
o o 

O Q 

z z 

O O 
3 3 

Z Z 

UJ UJ 

a. cl 
o o 



t- > 
z o 

M o 

D 

u. 

u z 

Ul o 

UJ Ul 

I— tr 
< o 
_i u. 



UJ 

z 

cn 

d o 
x z 

U D 
Z -I 

c \ 

CC X 
CD U 

z 

> o 
o cc 

□ Q 

a \ 
X 
Z U 

o < 



o 
in z 

O D 

Z -I 
v» 

Ul < 

UJ Ul 

CC X 

I- u 

< 
> tr 
cr K 

O v z 

h x in 

< z *■< 

tr > — i 
-ceo 

CL < CO 

cn _j z 

Uj Ul 

cc z 

cr i- 

co D < 

u c u 



< u 
« u 

_i in d 

mO(|) 

I z z 
a 

o < 
z z z 

•— UJ _l 
cn Q D 

O UJ CL 
Ul 

e> z 
> z => 
tr 3 < 

< _i tr 
z i- 

O UJ 
Z t- t- 

D tn 

DUO 

tv < a. 



Ul 

z 

o tn 

I— I »— ( 

-I Q 

a 

z cn 
o ~D 

U X 

o 
> z 
z o 

tr 

t- CO 

tn tn v 
~ o «t 

O UJ LU 

1 I 
O O O 
z < < 
D tr cc 
j i — t— 



u 

Ul z 

z o 
< 
ui tr 
cn i 
<x a. 
Ul < 
cn « 
i- a 
a 



u tr 
ui a 
z z 

ijj U' 

cn 
< < 

Ul LU 

CD W 

Q Q U- 



cr; 
> 



cn cn o 
< < tr 

hmO 

con 

LU Uj >-> 

n z a 



z z 

Ul Ui 

tn tn 

> > 

cn in 

cl a. 

cn cn 

LU Ui 

tr cc 









a 




lU 


Q 


p 


u 


cc 


cr 


U ; 








— ^ 


cn 


cn 


o 


a 




□ 


c 




cn 










UJ 


< 




C 


1 


a 


LL 


i 


i 


cr 


t 




L0 


c 






> 


ON 








cc 


K 


tr 




D 










t- 


CS 


Ul 


o 


z 


< 






3- 


c 


cr 


u 


G 
















CL 




U 


C 




U 1 


< 


< 


< 


tr 


Lu 


tr 


cr 


cr 




CL 


u. 


Ll 


U- 


IT 1 



o ru o «■« ru th »^ o ru tii 

nvinnimtMnnno^rordnno — o o ^ to o- - - rj^-incoo^riinTCDO 

ooo-» — '- i '^- < ' - r(irdrjr«jr(irj«*CD«s-«-'9'»TNCC ajcocoiiio-o-o-O'O'ff-O' 

CSGDCDlDlDCDlDtBltitDCDCDro l^)4n^nlnl^)lOl^)U^mlnlr) 





o 




fu 






o 


O 


o 


n 




N 










O 


O 


c 





IN 


CO 


QO 


cr 





299 



E 
01 

-p 
m 

ZJ> 

U) 

3> 
P 
O 
P 
IB 
P 

•rH 
IX 
m 
Oi 

ce 



<4- 
O 

in 
P 

Oi 
XI 
P 
O 

in 



XI 



t 
o 

-p c c 

a c. O 

£ -rH -r-l 

17 £ -P 

LT) ai u 

■a <*• 

IT - C 

fQ "O l — I 



c o 

CTI U 
•H P 

10 nj 
W 

C - 

<Q X 

>0 

u p 
<+ o 

P -C 

in p 
o o 
C E 
a, 3 
to Qj 

■ri C 

Q CL 



in m 

at ai 

P P 

TJ TJ 

a> ai 

u u 

o o 

P P 

CL £L 

I- P 

o o 

c c 

-i-l rH 

z z: 



zr- 
P 
o 
p 
no 
p 

■rH 
CL 

in 
ai 
cr 



l— 



c 
o 
E 

3 

ai 
c 
a. 



IQ 



P in in 

o> p p 

a ai oi 

a u -p 

D C u 

m nj 

- (j a 
m 

in in i/i 

O (Ll Ql 
f- *- 

XI D 3 

•H TJ TJ 

U. Oi 01 

U U 

.. O O 

E P P 

in X LL 

r-H p p 

a. o o 

o c c 

Ql rH -rH 

z z z 



0) 

p 

o 

JZ 

p 
o 



o 
E 
3 

01 

c 



Ifl rH 

J- p 



E -P 01 0» 



Ql U P 

ECU 
•D nj 



o. in u a 

in c in in 

oi id ob a* 

P P P 

3 c 3 3 

•O Oi XI XI 

0j >-i 0i 01 

u cn u u 

o o o 

f- -a t- (- 

a. c cl a. 

•D 

r-H f— I I— I 

ID •> TJ W 

u in u u 

•H -rH -rH rH 

TJ Id TJ TJ 

ID O ID 10 

cr p cr cr 

(- H (. f. 

u_ o o 

01 - ill 01 

> x> > > 

rH tH r-l r-l 

in o in in 

ID U it ID 

> P > > 

C nj c c 

1 H (/) H H 



m 
— i 
II 

a> 
cr. 
•i 



i—i 
ii 





'0 






CJ 


D 


C_l 




E 




cn 










x: 


m 


<C 


o 


cj 


u 




-p 


i-H 












in 


II 




-p 


-p 


p 




< 


V 


(B 


3 


3 


3 








r-l 


O 


O 


O 




TJ 


Oi 


c 


JZ 


x; 


x: 




C 


cn 


o 


-p 


•P 


P 




ID 


<L 


E 


■rH 


-r-l 


rH 








3 


3 


3 






in 




Qj 










■H 


<D 


c 


i> 


C> 


0- 




-P 


r-l 


CL 


O 


-0 


-0 




■H 


c 




1 


1 


1 




JZ 


o 




•0 


•0 


o 




u 


E 


p 




T-l 


1—1 




C 


3 










Lj 


o 


Ql 


> 


Oi 


Ql 


Cl 




P 


C 


OJ 


cr. 


cr. 


cr. 


D_ 


C3 


a. 


01 


< 


IB < 


< 



-t-> 


O 




r-i 






c 


II 




LJ 




II 






.'i 


o 


w 


Cl 


p 


o 


cn 




<t 


<C 


f 1 


.. 


t 1 




u 


CJ 


JZ 




x: 


p 


p 


p 


•rH 


•rH 


■rH 








l> 


o- 


0- 


-0 


-0 




1 


1 

•0 


1 


i-H 


T-l 


T-H 


01 


0i 


Oi 


cr 


cn 


CT. 


< 


<i 


< 



-a 
C 



o o 

p p 

(Q IQ 

(- r- 



Cj -rH -rH -rH ■ rH 



CL 

in 

Qi 

or. tr 



CL CL 

in m 

Ql Ql 



O P P P 

d o Z) 

- o o o 

. JZ JZ JZ 

a p p p 



t- 3 3 3 3 



r- Cl 
O 

P 0- 
•D 

P Cj 

•rH 

ao 
in 

ai - 

tr nj 



d o 

o E 

x: D 

p Hi 

'rH C 

3 CL 



P 
o 

P o 

IQ rH 

P c 

rH O 

Q. E 

Ql Ql 

cr c 

n 

p 

3 Ql 

O r- 

x: Qi 

-p > 

■rH QJ 

3 cn 



P Q 
o 

P CL 

10 . 

P o 

•rH 

a. a 
l/l 

Oi i 

CC ID 

•rH 

P C 

3 O 

O E 

JZ D 

p ai 

■h c 

3 CL 



P 

o 

P ID 

IQ -rH 

P C 

rH O 

CL E 

in 3 

Ql Q| 

cr c 



P 
o 

Q_ P 

P IQ 

3 01 P 
O 

x: 
p 



01 

P r-l 

qi a 

> in 

rH Ql Ql 

3 in a: 



nj 


1 CL 


CL 


CL 


CL 


CL 


0. 


0. 


z 


z 


Z 


Z 


Z 


z 


z 


z 


z 


z 


in 


1 «* 


«T 


*t 






<* 




t 


<^ 








«t 


«cr 


«t 






Qi 

in 


1 O 


O 


o 


o 


O 


o 


o 


o 


o 


O 


o 


o 


o 


o 


o 


o 


o 


ID 


1 CJ 


CJ 


o 


U 


CJ 


CJ 


CJ 


CJ 


CJ 


o 


CJ 


CJ 


CJ 


CJ 


CJ 


CJ 


CJ 


01 


1 Q 


Q 


Q 


Q 


Q 


Q 


Q 


p 


a 


a 


Q 


Q 


a 


Q 


Q 


Q 


Q 


in 

rH 


1 Z 


Z 


z 


Z 


Z 


Z 


z 


z 


z 


z 


Z 


Z 


z 


z 


Z 


Z 


Z 


Q 
























































CJ 


CJ 


CJ 


<J 


u 


CJ 


CJ 


CJ 


«t 


1 O 


CJ 


o 


u 


u 


CJ 


a 


o 


CJ 


O 


i—i 


rd 


rn 




in 


*0 


S 


O 


1 *~i 


ru 


n 


«t 


m 


-0 


r-v 


CD 




















CJ 


1 o 


o 


o 


o 




o 


o 


o 


o 


o 


O 




o 


o 


o 


o 


o 


a 


i cr 


cr 


cr 


cr 


cr 


tr 


cr 


cc 


cr 


•r 


cr 


cr 


cr 


cr 


cr 


cr 


cr 


z 


1 Q 


a 


Q 


Q 


Q 


Q 


Q 


Q 


Q 


Q 


Q 


Q 


Q 


Q 


Q 


Q 


Q 



300 




302 



E 

4-> 

</) 
»> 

c/5 



o 



to 
c 

O) o 



$_ Q^> >£•< Kfj<^xOXKjj Z X^aXQi^J<Z o<z 

•<- uj xzQs<aviiii><z3 3i/iq» ^x xh» z o<z a ujujx^x x>— ujk^x xh» 

Q -_J»— J^3 —J >— wU/ICAOXS/) a£X X^iJXJJ jH-iOJ^J!<3'/)l 

£ ^ UX O 3_JO^Z<3 3 JJ ZZ3X3/)UJ 3£*-»- 3 3 -U/> 3 3 4J 

cc -*X3. jJZj<*-»- Z3Z.X3*- 3K J 3»-->-«3 Q jj^> 3 >ZJ 3 3— 

S ,toz^x-3«^i i x— i — * <u_j^xa._u2:jc>-t— szxcjzoi kuj^zi i <jj^I4j 
-i- t i i i i i i — i i— i i '/)ZjiZJZ3zax^ 3— '-xx i xxxxjjajjja: jzdoojjz juji 

<4_ +j — v/i /ii/)i/)(/)./)-./v/v/)i/)^v./)i/)./x t I i I I i 3ZojZJZ3<««4 4ZZ I I I I i ZZ I I I I I Z 
O a»33333333033J33i-'""-f I I I I I I I XXXXiXXX J JJJ J uOwO^.n-03 
_ T «ZZZZZZX^XaCZX l XZUOU'JJUU«<««3333333^2^JJUJUJajaS33333 I 

S J, ZZ^ZZZZ— ««— ^t—ZZZZZZZ"^^^^ uO 
-O 0) ZZ3333333XU.U.O.U.^U.ZXZZZZZ33333333333333>->a]9Saa>>>S21saa« 

° _ Jja)SOSSaaoOJOO^OZZZZZ^^JJ2J333JJ333J3« <•< 3 

ZZ ZZZZZZZ3033a33iJiJ4JUJJJJUJ:UJJjjiJaJiJiJZZZZZZZZZZZZZZU 
•r- 334.tLU.li4U.X3333333XXiXXK^aZZZZZZZZZZZZZZ333J33J3333333J 

■a o> jjjjjjjjjjjjjj 

333a3lUQ00333U9S333303aa333333a333J30iU3^^J^J^J^33^3 



c c 



i/) "C — — — — — — — ^ — — — — — — — — — — — — — — — ryj 

Q U 3030333333003000033000333303303033333000300030003030 



u 

a) zx xh- x xxx>- izxxxh z zx x»- x x»- zzxx 

O Z^3XJ^J<Z333^J<^333V) *X Xt— Z^3X3V1 ZZ.3X3^J<^33 

_ vi U<Z 3 jjluX^ HUXZ aJ ZZOX3iflJ<Z 3 -u - J < ^ a uiuJXZ 

"5 3>- UJX33 3HQ.aiZ3^3^auJ3Q>-Ot-«J<3 a JJJJX33 3KDXZ3 (3^aaJ3-J»- 

4- T < Q.OJ 3CH-t— v» 3 ac_J*- TC_J»— jjx 3 a»-aiu X*—*- :VjJ3TC*-»- <n a£_j 

i— <3 — ' ^»^> ZJJ^IZJ U3^ZZ3ZJ3^ZiaiCXi-»- «rt ZJJ^I 1 /' JJ^ZZ3ZJ3 

cn ZiflZ3X"*3-<'-3Z£-«J-'-JZ<-0-«»-'/) <JJ^ZZ3X«3^Z3Z-3->"3Z<«U 

c /n/ia^uj34jji,JXJi kzizji i xzi xu4J<«j-^Jiusuxjj^j;j4.'ji • xj. i 
c Oh-S'-J I I I I I I I >->-X I >> I I JUUJ IOII 3ZUJZJZ3 1 t t I I I I I I X I I I I >•»■ JJ I >- 

r- q »— JJ ^i/ix^X^KXXVii/ruJtfii/Wli/lujUi I JUUJ • I I I I I I XJCiXJtaC CXJC JCuJOCtX JCX* - *" • 

■M t- ZIl- .u -Ujj J'iJ^J.jJ— — I — —— JJ<C JJXH/l^»<^»'^"WWT/lh-P-r-^-^-»— r» 4 4 I — — 

•r; +? ->-»Z-*-l_J J -J-J -J-J X XX X XXX JJ4S ZZ J J J J 303 J J j j j j j j j j j j j j>»- > > 

* ,r-J<JJi l\iaiai333J3JJS9X U ZZZZZZZ— <-»-<-«-»-J333JJ3««« 

„, s_ 0. fJ. JI1.££ZC£J U U UJJ-JJ UP— flp-Ha U.AU.U.HlliJ'3J-J3 33 , JJ> JJ 

a, u/it-TKzaaaa^jojjjjjjj m>- hi- aaaafluazzzzzzz J333333 < 

"2 Z 3J3JJJJJJJlliaiaiJJH J ( .- ( -P-p- h -i—HH«H-.- ( T ZZ22 2Z2IJ2I 

° ° <3^-J_l 33 J3JJ 

^ jc>- • jj saas aaasaaaosa^jizxic xx>^»^»ojjjjjjj jjjjjjjjjjo 

2: >zj-f'-p-f-p-'— f— •"a.aa.a.ia.Q.iifxxxxxzzzzzz^zxzzxzZiizz^z 

O 00 Zj£3— 4<<<<<<333333"3333333333333 

I ■<- J^JZjZ£Z£££i:£ U£ZIZZJCZZZZZIZ£i;i;ZI»,JJJJJjjJjjjjjJJjJJj 



I 

Q 

(_> L.j4j/)<a.aaa.aiiaaaaaaaiaaaxaaaaaaiia 



o c3*- q<sjcoctc xvxx x.-x.x.i.'x.x. XXJCTCX.TCXTCTCTCX. jc jcoc "331 sj a osaxoaaaa o-o anas 



to 



"O^^f^ ^ — 1 . r—4 *—l *i <■ «*^— — — — — — — — — — — — ■ « « — — — ^| ^ ^^^^p^^iH.^"^^ 



303 



Table C 

Code English Description 

01201 lb PLEUK1 SY-HL t X AH 

01202 Ttt PLtUKl SY-tXAM UNKN 
0120J Tb PLEOk 1 SY-MlCkL OX 
0120H lb PLEUKlSY-^LLT UX 
01205 lb PLtUklSY-hl SICLUG UX 
0120b IB PLEUklSY-LlP TEST 

01210 lb THlkaCIC NLCES-UNaPEC 

01211 lb 1HLKAX NUuE-NU EXAM 

01212 lb THUkAX NOOE-EAAM UNKN 

01213 Tb IHLkAX NGLE-MICRU UX 

01214 Tb lHckAX NUUc-CLLT OX 
0121b lb IHLkAX NOLE-HliTU UX 
0121b Tb 1 Hlk A A huuc-UTH TEST 

01220 1S0L TKACHtAL Tb-UNSPtC 

01221 1SOL TRACHEAL IB-NO EXAM 

01222 lbUL 1RACH Tb-EAAM UNKN 

01223 1S0LA1 lkACH 1B-K1CR0 UX 

01224 IbUL IkACHEaL Tb -CUl T OX 
0122!) 1SULAI TkACh Te-HISTO OX 
01226 liULAl TkACH Tt-LTH TEST 

01280 KESP Tb NEC-ONiPEC 

01281 kESP lb NEC-NL E A AM 
012B2 ktSP Tb NEC-cAAM UNKN 
Ukijj KtSP Tb NEC-M 1 CkC UX 
012B4 kESP lb NEC-LILT UX 
012B5 kESP lb NEL-hliTL OX 
012bb kESP Tb NEC-OTF TEST 

0203 PRIMAKY PNELMLMC PLAGUE 

0204 bECuNUAkY PkcLMUN PL AGUE 
020d PNtCMCNIC PLaGLE NQS 
0212 PULkUNAkY TOLARtKiA 
0*21 PULMJNAkY ANTFRAX 

0310 PULKJNAkY MYLCBACTERIA 

0330 BOkOE TELL A FcklOSSIS 

0331 BOkGc TELL A PAk APERTUSS1 S 
0336 hHUOPlNG COCbP NEC 

0J39 hHOOPING COGuH NOS 

0391 PuLMUNAKY ACTINOMYCOSIS 

U521 VAk 1CELL A PhcLROMTIS 

0551 PUSTMEASLES PNEUMONIA 

0730 LkNITriOSIS FNELMLM A 

07*» 1 tPlOEMiC PLcCkCUYNlA 

09d1 SYPhiLiS OF LLNG 

1124 LANLlLiA^lS Lf- LLNG 

1110 PKIF.aRY COLC1G1UIU0MYCUS 

HbOb H1ST0PLASM CAPS PNEUMON 

libit) H1S1UPLASM UoB PNEUMONIA 

llb9b HISTOPLASMOSIS PNEUMONIA 

1212 pAkAGLMMl ASlS 

1221 tCHlNLCUCC GKANUL LUNG 

1304 lOXuPLASMA PrstlMUNlTIS 

135 SAkCOlUObli 

1363 PNEUMOCYSTOSIS 

1370 LATE tPFECI lb, &ESP/NUS 



(Continued) 

Code English Descriotion 

lo20 MALIGNANT NEU TkACHt A 

1622 MAL1G NEO MAIN bkONCHUS 

lo23 MAL NEO UPPtk LUbE LUNG 

162H MAL NEO M10ULE LUbE LUNG 

1o2d MAL NEO LOKER LUBE LUNG 

102b MAL NEO BkONCH/LUNG NEC 

1029 MAL NEC BkONCH/LUNG NOS 

1030 MAL NEO PARIETAL PLEUkA 

1031 MAL NEO VI SCEkAL PLELKA 
lb3b MAL 1 G NEOPL PLEUkA NEC 
163* k A L I u NfcUPL PLEUkA NOS 
lb42 MAL NEC ANl MEOIaSTINUM 
lbHJ MAL NEC POiT MtUlAST 1NUM 
164d MAL NEO MEOIASTINUM NEC 
1649 MAL NEO MEUI AST 1 NOM NOS 
l65ci MAL NEO THLkAX/KESP NEC 
lbb9 HAL NEO KESP SYSTEM NOS 
1951 MALIGN HEOPL THOkAX 
1970 SECONUARY MAL 1G NEU LUNG 
19/1 SEC MAL NEO MEOIASTINUM 

1972 SECCNO F AL 1G NEO PLELKA 

1973 SEC MAL 1 G NEO KESP NEC 

2122 BENIGN NEO TRACHEA 

2123 BENIGN NEO BRONCHOS/LUNG 

2124 BENIGN NEOPLASM PLEURA 

2125 BENIGN NEU MEOIASTINUM 
212b BENIGN NEO RESP SYS NEC 
2129 BENIGN NEO RESP SYS NUS 
2133 BEN NEO R IBS/ST ERN/CLAV 
2142 LIPOMA INTkATHUkACIC 
2j11 CA IN S1T0 TRACHEA 

231* CA IN SITU BRONCHOS/LUNG 

2;>ld CA IN SITU RESP SYi NEC 

^319 CA IN SITU RESP SYS NUS 

2357 UNC BEHAV NEU LUNG 

235b UNC BEHAV NEU PLEURA 

2359 LNC BEHAV NEU RESP NEC 

2391 KESF1RA1URY NEOPLASM NUS 

3061 PSYCHOGENIC RESP1R UIS 

4151 PLLMON EMBOLI SM /INFARCT 

46410 AC TRACHEITIS NU UbSTRUC 

4b411 AC TRACHEITIS W OBSTRUCT 

4obO ACL TE BRONCHITIS 

4661 ACCTE BRONCHIOLITIS 

4bOO ALEN0V1RAL PNEOMUN 1 A 

4601 RESP SYNCYT VIRAL PNEUM 

4B02 PAR 1NFLLENZA VIRAL PNEUM 

4B0d VIRAL PFEUFUN1 A NEC 

4b09 VIRAL PNEOMONIA NOS 

4dl PNEUMOCCCCAL PNEOMONIA 

4B20 K • PNEUMONIAE PNEOMONIA 

4b21 PSELOOMCNAL PNEOMONIA 

4b2* H. INFLUENZAE PNEUMUNIA 

4b23 S1REPTLCLCCAL PNEUMUNIA 



304 



Table C (Continued) 



Hdtti 

4o29 

4G3 

4841 

4d43 

4d45 

<»8sb 

4847 

4B4d 

485 

48b 

4870 

490 

4910 

4911 

4912 

4918 

4919 

4920 

4S28 

493CC 

49301 

4S310 

4931 1 

49390 

4S391 

494 

4950 

4951 

4952 

4953 

4954 

49d5 

4956 

4957 

4958 

4959 

49b 

5C0 

501 

502 

503 

504 

505 

5060 

5Cbl 

5062 

50bJ 

5064 

5069 

5C70 

5071 

5078 



English Description 
:>1 APHILUCUCCAL PNEUMUN1A 
ttALlcRlAL PNtCFUMA NEC 
b AC 1 1 K 1 mL PNcCfUMA NUS 
PNhUMuM A J LKGAN1SM NkC 
Huh CM H CYlLPtG 1NCL 01b 
PNECMUN1A IN feF.ULP COUCH 
FNhUMLN 1 A IN ANTHRAX 
PNECM IN ASPtRll LLUS1S 
PNt CM IN U1H StS MYCOSES 
PNt CM IN INFLCI 01 S NLC 
BRUNCLPNbUMUN 1 A LKG NJS 
PNtCMUNiA, chGANlSM NUS 
1 NP LClNZ A hi 1H PNtCMUNIA 
BkUNChlTIS NUS 
olMl-Lb CHK dKLKhlllS 
MUCLPCKUL CHK kklNCHlTIS 
UbSTKUCT CHu cftJNCHlTIS 
CHKCN1C BKuNCHlTIS NtC 
CHRONIC BRCNlF 1 T 1 S NOS 
thPHYStMAlLCS BLbd 
tMPHY StMA NtC 
b AT AS1HMA H/L SI AT 
W S1ATUS 
k/L SIAT 
h STATUS 
STA1US ASTHM 
ASTHMAT 



ASTri 
ASTH 
ASTH 
ASTH 



tXT AS1HMA 
INT ASTHMA 
INT ASTHMA 
ASTHMA W/U 
AoTHMA k SlAlLS 
bkUNCHltClASIS 
FaRMLR b • LUNb 
BAGASSUS1 S 
8 1 RU-F ANC 1 tk S 1 LCNG 
iUBtRGSIS 

MACl WCiRKbkS* LUNG 
MUSHRUUM WbRKbRS 1 LUNG 
MAPL BAkK-Slk 1PPRS 1 LUNG 
"VENT 1L AT 1UN" FNEUMUN1T 
ALLhKG AL VELL/PNbUM NEC 
ALLLkG ALVhlA/FNEUM NUS 
CHk AIRWAY UbSTRLCT NbC 
CUAL rfUkKckS • PNbUMUCON 
AibbSTUS IS 

SILICA PNECKCCCN NEC 
INUKG UUbT FNcCMCCON NbC 
0US1 PNtliMUNUP ATHY NbC 
PNtCMCCUNlLSiS NCS 
FUM/VAPUk tJRCN l/PNEUMUN 
FUM/VAPUk AC PCLM EUbMA 
FUM/VAPUk UP ktSP 1NFLAM 
FUM/VAP AC kcSF CUNU NEC 
FUM/VAPUk CHk RESP CCNU 
FUM/VAPUk ktbF CLNU NUS 
FUUL/VUM1T PutLMQNITIS 
UlL/tSSbNCb PNbUMUNlTIS 
SUL10/L10 PNtLKOMT NbC 



Code English Description 

•jUdO AC PUL KAN IF D/T kAU 1 AT 

5081 CHK PUL MaMF U/T kAOIAT 

5088 kESP CONU: bXl AGtNl NbC 

5089 KESP CUNU: EXT AGENT NUS 
5100 tMPYEMA WITH FISTULA 

5109 tfPYEMA W/C FISTULA 

5110 PLEUklS* W/U EFFUS UK T8 

5111 8ACT PLEUR/EFFUS NUT TB 

5118 PLELRAL EFFUS NEC NUT Td 

5119 PLEURAL EFFUS 1UN NUS 
^120 SPENT TENS PNEUMUTHURAX 
512b SPCiNT PhEUMOTHUKAX NEC 

5130 ABSCESS LF LUNG 

5131 ABSCESS LF MEul AST INCH 
D14 PLLM CUNGEST/HYPUST ASIS 
515 PU S T INF L AM PULM F1BRCS1S 
51bO PLL ALVEULAK PKUTblNUSIS 

5161 1CIL PULM HbMUSlDbRUSIS 

5162 PLLP ALVEULAR M1CRUL1TH 

5163 101U FieRUi ALVbULlT IS 
3l6d ALVECL FNbLMUNUPATHY NEC 
5169 ALVEUL F Nt CMUNUP ATHY NUS 

5171 RHELMAT 1C PNEUMONIA 

5172 SYST SCLEROSIS LUNG 01S 
5178 LLNG 1NVULV IN UTH U1S 
51bO PLLPUNAR Y COLLAPSb 
5181 INTERSTITIAL EMPHYSEKA 
3182 CLMPbN i A T LRY EMPHYSEMA 

5183 PLLPONARY EUi INUPH I L IA 

5184 ACUTE LLNG EDEMA NbS 
3185 PCST TRJUh PULM 1NSUFFIC 
51dd LCNG DISEASE NEC 

5190 TRACHEC STUPY CUMPL1C 

5191 TRACHEA/BRONCHUS U1S NEC 

5192 ME C 1 AS T IN III S 

5193 MEDIASTINUM DISEASE NEC 

5194 DISORDERS LF DIAPHRAGM 
Dl9d kESP SYSTEM DISEASE NEC 
5199 RESP SYSTEM OlSbASb NUS 
71481 kHECMAT C 1 U LUNG 

733b TIET2E»S DISEASE 

7484 CCNGEN 1 T AL CYSTIC LUNG 

7485 AGENtSIS UF LUNG 
/48b0 LUNG ANCMALY NUS 
74861 CONGEN EkUNCHltCT AS1 S 
74869 LCNG ANCMALY NbC 

7488 RE SP1RAT0R Y ANOMALY NtC 

7489 RE SP1RA TURY ANUMALY NUS 

75481 PECTUS EXCAVATUM 

75482 PECTUS CAR 1NA IUM 

7563 RIB STERNUM ANUMAL NEC 

7566 ANOMALIES LF DIAPHRAGM 

7dl5 CLCBBINC UF FlNGEkb 

78600 RESP IRA TURY ABNUKM NUS 



305 



Z »U Z -J Z -J*- 'J o 

QXl OS -JO. O *J M o.oo< yu-nz zyioj 

UlQ. <-J Oluuj OOS 3 ijj 31 1 Zujtxi ZOD ui>*<X 

vng /)J«Jja^Z I I xiuuj v»ZXIO U<UXX^ ^-J -Oi-o^ 

«JZ ZJ.^ZI I u^saJ^JajZ-uja 3ZxlOX I < XZxl< xae 
— «xi xxjjzxjjja.ojiJjj a.^j<xiXJj4Joj o.«»a 

IZ Z»»-X<< I l»-p-Uj'J3aOl • 4J-53Z<uJ3H-Z-JaCX ZliJ 
= Z3C 3<^3XXXX30IUt I3I»IZI XX "J ONf-U XI-OZ 

° Oxi zj3zao«zr^i z^i z.tx>«*>^uzza£i < xi 
£ z^- /ixux^xxxajjujaz33Z333ae acz <-«i8u>4 zaca, 

CL X^ajaOOJ^33XXZ3*Z3-T)3JD"*U.X ZXH- <IZ 

»- xl -^-ZZ^QatX30 -•»- -<»-ZZ"J-"' 3ff-»03\Xt>-iJ0 

" </»V13 JJI 333333X3XX3X ■»< - <30>^Qja<Z' , * ,, »UJ 
'XI —X.X'— sJX.uJxi2:XxlXI3*-Xi:3*-xlXX 36 xzz sssooj^saj 

a.o.xxaaz'J<^3«<3X3X3uu.zzux<aa^j9 

JUZZZZZ "UjM'jJKXX>-XKXZaJ^id<^JXZ OX 

«2 J33- — — EZZZZZ ZXJ4J4 ~-ocxi aJixlZ OJ 

«_ «^^««<«4<^3^33'J^OJOUQ,a>4X^IZZZLUiUUI^XZ SO 

at ^i/w»:xae jcacae «iz^xz^<*<s«*o<— ur-xixsr-aeac jg«p-< <xx 

^ li3Q'/)'/l</)^^i"*'<'f i"JJJJJJ3aS> l *S" , OJJU>lUiXfi<il) Bl/ )< 

*J 
c 

o 
<-J 

o 

"S 3. >■ Z onuj.uaytQ z z -nz 

t- z una o oxaxo-'wxouo ojzz xiz 3xi 

o 3 jj— O-L/-* xi ii^t-j33<o_j^4j za.jjxiza.-u jx 

OJ _J-n Zxlt— »-»- m^3UJJ3UO^ZZii3&XuJ3&ZUa 

Z S3 n'/NU Q3J t U J-l I -J3'Xl XIO. I 331 • 3X1 I I 

zt/i«z ax. wi< i ji^u jaa.3^ i u^iazz 

2 3/13 Z J XI X JU I i o I J33 1 3^>^ I 9^333 

X — »-o.£Xut J i i /i^xaaj'i^jj t i i •./»»* a aji/i-^aj i 

£ z 3 *-z^ /»Z3>- j'/>*.a'X-*<-»xja6-*^<^a«Q6^«ffla:-«''»acQ6 

.° o a ju.y- acjt^ ut-j'j-*-* ctuc-* jc'-jxixi 

V f»-J I '» <^XX^J ut<£. 4Z-KXUJ XZ 

Q. I— < t»-«Z 1 1 I ^ KXl X, UXJJ XI U XlZXl iJ X! 

T < 3x-*xi xj/»ae*t— ajjjX3>ox/imjjX3><<>x/i 

^ a-njx xj<xi >-«zxx'j-«-* , u3 a-zxx3«-*^3au.u. 

ac w./iixi_jo ozzzz atac3»-*-ix.u.;/v./»z-«Z3*-*-a.u.;/v./ix-*33 

aj »-<3 -« jcjj v-<o-^-* 3 ^ac "vac 

Q Zjj»- -"_J jt_jl 131 J<h-xl xixi xixixl xi j>- xi xixixixixixixit— xixi 

_ jjz«2C >-<_j*/*<j^z < jCjcjcoc acac^jcxi— x jixacac^ac'XX'-acac 

°S »a,3C-J — Z3 £J<omj<uxx33JJ3JJJJJJJ33J333JJJ3 

X3-»3X.\XX>»1£3 Xfl.O.XJ-'-'Hi-MMf-Ht-.— < 3h»Hl- f— r-t-»«^X>»— 
>— UXl-"JJJ^-n JJi alXxJJJJJUvJJ iJZJJJJJOJJuJZJJ 

J li-^X3XZ-ajZ->^ZZZai^«««« <<<<<<<< «.«* 
,5 -»J*- 3xi o<xa-« u o-nas-^xiac j£j6JCj6X%J6<xJCxa6aca£xiacx*<xa£a6 

X3X^-JX<l'J<XX4«^<XXXXXxa.XXJ.XXXXXXXXUiXXXX 

o, 300HN-n*'fl0i*fly^\-<fl3^300«000333^^^HHH«i\.'n 
O "S 0-J0<D9D'0 89Da^79 | U > 3 t J«UOO'J3UOUUOOO3O3UOOO<3Oa 



s- 

u 
en 



306 




XKUI 

ui < «-« cs 

O OC < < 

< O Q. O 

U X UI 

K I H 

k i tn 
tn ui ui ui 
uj o C9 I 
x z < o 

I o I 

1 o z 
t- K o 
D x in « 

0) H UI H 
O X « 
I- Z U x 

in _i — 
o oc u 

M UJ UI 



rsi t> 



09 
Id 
-I 

> 

> »- 

OC <J 
< UI 
-J O 

O 

D O 

oc -i 
»- o 

to 

UI Q. 
O UI 



< 

UI 
X 

u 

> < 

V X 

UI z 

Q > 

<r K 
O < 
O _l 

-J 0) 

< — 

o z 

> - 



UI 03 
oc UI 
Z> -I 

o 

UI X 

u z 

o > 

oc oc 

a. < 

x 

a o 

< oc 

u ui 

< a 
oc 

H _l 
< 
X o 
H O 
O -I 



u 

< 01 
_J o 

-I (J 
< 

UI < 
O _l 
Z 3 
> t- 
OC 0) 

< « 
J U 

u. _> 

o < 
UI 

UI o 

OC Z 

D > 

»- OC 

D < 

(0 -I 



— oc 
o) « 



u 

UI 
OC Z 

< (0 

a. o 
Ui _i 
oc o 

-J < 

2d 

o »- 
z to 
> « 
a: u 
< 

_i < 
ui 
a x 

ui <_> 

X < 
K 0C 
O t- 



> 

r z 
o o 

H •-• 

0) 

O U 
Uj 3 
X 0C 
O I- 

< to 

es 

u 
U UI 
O oc 

Z _l 
o < 
>-> uj 

to X 

M O 

> < 
UI tc 

0C K 



oc <-> 

— to 

< « 
a. > 

UJ M 

OC Q 

_J > 

< OC 
Id UI 

X z 

<J 

< _l 

oc < 

I- UI 

o 

OC Z 

UJ > 

I oc 

K < 

O _l 



to 

!*§ 

Q 

< K 
< 

x oc 
Z UI 

> a. 
oc □ 
< 

-i -i 
x < 

X UI 

U C9 

< Z 
OC > 

I- oc 

< 

to —J 

to X 
>- I- 
-J o 



§ UI 

_l 

»- 

< o 

oc z 

UJ o 

a. oc 

O 03 



_i 

4 

U 

O 
O _l 



to 

~ (0 

U O 
x I 
UI U 

z 
_J o 
< oc 

— CD 

X 

U U 

z o 
o 

OC Z 

03 O 

OC CO 
UJ oi 
X <_> 
H Z 
Q -> 



0) u 
a. ui 
o z 

a > o 
to o 
-i a. oc 
< o a. 

M I— t 

X 03 X 

U O 
Z O 

O Z _l 

oc z> < 

O JM 

X 

oc oc o 
Ui UI z 
X X o 
K h E 
O O 03 



0) H 

o to 

z < 

© -J 

< a. 

-> a 

a u 
< 

o oc 

z o 

o x 



UI 

oc 

3 tn 

»- o 

D -J 

to u 

I- < 

< —I 

0C 3 

UI H 

U (0 

< 

-I u 

-I —I 

< < 

t-t +-t 

X X 

u o 

z z 

o o 

oc a 

m m 



u 
ui 

z z 
o 

oc 

< < 

0. o 

UI w 

OC _J 



< < 

X X 

(J o 

z z 

o o 

oc oc 

a) m 



u a 

ui o 

Z O 

tn 

z o 

o u 

- < 

o t- a 

z < o 

D 0C X 

J lii H 

a. 

u o < 

□ oc 

_l D 

UI < UJ 

OC _l 

D X 0. 

t- u to 

<J z z 

z o < 

3 oc oc 

a. m K 



^ t> c — r» n * o n * *> c r* tn o- •> n to o- * — m o tM n to — 

OONNntW'O'O'O'OONNNMMf'ffrO-OrilNNNO'f^tlMMhN 

nnnnononnnnnnnnnnnnnnnnnnnnnnnnonnn 



Principal Diagnosis 



DRO 1C, MDC04P, Minor Procaduras, Sign and Sgmpt 



Coda CPHA Abbraviatad English Dascription 



V426 LUNO TRANSPLANT STATUS 

V550 ATTEN TO TRACHEOSTOMY 

V712 OBSERV-BUSPECT TB 

3061 PSYCHOGENIC RESPIR DI8 

3110 PLEURISY W/0 EFFU8 OR TB 

91 IB PLEURAL EFFUS NEC NOT TB 

9119 PLEURAL EFFUSION NOS 

914 PLUM C0N0E8T/HYP08TABIB 

9184 ACUTE LUNO EDEMA NOS 

7336 TIETZE'S DISEASE 

79481 PECTUS EXCAVATUM 

79482 PECTUS CARINATUM 

7963 RIB S> STERNUM ANOMAL NEC 

7819 CLUBBING OF FINGERS 

78601 HYPERVENTILATION 

78602 ORTHOPNEA 

78609 RESPIRATORY ABNORM NEC 

7861 STRIDOR 

7862 COUGH 

7863 HEMOPTYSIS 

7864 ABNORMAL SPUTUM 
78652 PAINFUL RESPIRATION 

7866 CHEST SWELLINO/MASS/LUMP 

7867 ABNORMAL CHEST SOUNDS 

7868 HICCOUGH 

7869 RESP /CHEST SYMP NEC 
7931 ABN F I ND I NG-LUNO FIELD 
7942 ABN PULMONARY FUNC STUDY 
7951 ABN PAP SMEAR-OTH BITE 
7955 TUBERCULIN TEST REACTION 
7990 ASPHYXIA 



*<?f initions of DR<:>" = for Disposes and Disorders of rht> Re sp i t -i hovii Hy-i.. 
DRG IC. MDC04P. Minor I'ror piIim e c IHqii *nd hi q nip tow 



Operating Room I'r n c p d u r e 



Cnde CPHA Abbreviated Fnqlish Description 



7861 REMOVAL OF INTERNAL FIXATION DEVICl- 

7B71 OSTEOCLASIS 

78B1 DIAGNOSTIC PROCEDURES ON BONE, NOT ELSEWHERE CLASSIFIED 

7091 OTHER OPERATIONS ON DONE 

9227 IMPLANTATION OR INSERTION OF RADIOACTIVE ELEMENTS 



308 



> CD 


UJ 








u 


















r 










> 


> 


UJ 










CD U O < 0£ Z > O 


a 


UJ 








u 


z 


< 


to 










o 






CD 




z 


z 






X 


cc 


u 


Q.UUICM U O 01 CD UJ 


o 


Q 








X 


o 




M 








CO 


¥- 


u 


> 


UI 


t- 


o 


o 


< 


UJ 


< 




o 


O Z Z 3 < IU - O 0.Z 


z 


o 








UJ 


1-4 




u. 






o 




O 


UJ 


to 


«J 


u. 




1- 




o 


cc 


< 


<£ 


Ih ujo. zhzuo 




z 


UJ 


UJ 


u 






_J 




i- 


u 


UJ 


u 


UJ 


z 


a. 




o 


U 


u 




< 


o 


CL 


(J 


«0X£ JU < Ui«U 






O 


a 


D 


UJ 


< 


5 




u 


UJ 


cc 


z 


lr- 




a 


UJ 


1 


UJ 


UJ 






X 


UJ 




OLK ZC JZBO 


« 


> 


O 


o 


CC 


a 


_l 




U 


D 


z 






CD 


> 




z 


UJ 


1- 


y— 


to 




t- 


CC 


h- 


jkz o uj 5 a. 


u 


CC 


z 


2 


»- 


o 


D 


CO 




a 




40 




O 




ffi 


o 


z 


to 


to 


UJ 


t- 


i 




CD 


<Q«ll.><Mia;Z(-(i, 




< 






CD 


z 


Z 


(a* 


Q 




a. 


UJ 


UJ 




o 




03 


a 


o 


o 


X 


to 


UI 


UJ 


UJ 


zit-ot-ct-OHoy 


> 




> 


_J 






z 


u. 




CJ 


a 


o 


© 








03 






o 


UJ 


o 


CS 


X 


-> k to «d< z«3o 


or 




or 


< 


X 


X 






U 


tm 




i 


< 


Q 


Z 




UJ 




UJ 


UJ 




I 


z 


< 


o 


»- <ZCUK>5t-K< 


UJ 


< 


< 


Z 


a. 


a. 




»- 




_» 


i- 


UJ 


u 


UJ 


o 


o 


CJ» 


UJ 


o 


o 


o 


u 


X 


u 


i 




u 








z 


r 




•»> 


u 


< 




CD 




2 




IB 


< 


o 


< 


<« 


(- 


1 


u 




z 


<kqmOq.o.d a co a 






-l 


D 


> 




1- 


D 


< 








1- 








u 


< 


u 


u 




>- 




V- 


o 


i — 5 uj t- l. oauu 


a. 




S— 1 


§ 


_i 


_j 


u 


a 


cc 




Q 


UJ 


co 


UI 


UJ 


UJ 




u 






»- 


r> 


X 


10 


1—1 


\a a r < uj u. ohuu 




Z 


X 








g 






X 




o 




O 




w 


H- 




t- 


1- 


u. 


to 


t- 


UI 




uj uj uqouq:<ohm 


UI 




< 




u 






u 


s 






< 




< 


< 


< 


CD 




CO 


co 


< 




o 


X 


< 


CUUn •"•<! »-K 


a 








X 


< 












u 


u 




o 


u 


UJ 


CD 


UJ 


UJ 


tr 


i- 


z 


u 


X 


OOttDKUJKj<< 




111 


UJ 


UJ 


UJ 


§ 








UJ 


o 












X 


UJ 


X 


X 


C9 


10 


-1 






'KKE"3>- l <3irUIZX 


CD 


to 


to 


m 






< 


< 


UJ 


I- 


< 


(- 


cc 


t~ 


h- 


t- 


u 


X 


u 


V 




o 




cc 


u. 


UJCL0.irK-«CetJOC0CLCL 


1=3 








a 




cc 


BE 


CO 


< 


cc 


CD 


UJ 


to 


10 


to 




o 






UJ 




UJ 


UJ 




>'Z <UHOIO£U)CI 


u 


O 


o 


(J 


x 


o 






o 


o 


o 


UJ 


X 


UJ 


UI 


UI 


CJ 




X 




z 


cc 


z 


X 




khxxuUJiUI<UJUJ>> 


X 


X 


X 


X 




UJ 






=J 




X 


X 


1- 


X 


X 


X 


X 


X 


1- 


o 


o 


UJ 


o 


t- 


z 


[OQOIflLKt->Z>JJ 


UJ 


UJ 


UJ 


UJ 


to 


DC 


(- 




u 


-I 


t- 


u 


o 


o 


u 




UJ 


UJ 


o 


I- 


03 


CL 


03 


o 


M 


! >0 CD o ♦no- tD 0- 




CM 


n 




0> 






tM 


n 




Ch 






























•CMCMCM'ONO'O'CDO-0* — — 


CM 


cm 


CM 


CM 


CM 


n 


«0 




>o 


-0 


^0 


o 




CM 


m 


* 


o 




CD 


Cf 


o 


—4 


n 




m 




O 


o 


O 


O 


O 


o 


o 


O 


o 


o 


o 




N 














N 


CD 


CD 


CD 


CD CD 






«* 


«t 


f 


* 






«r 


«• 


"* 






N 


rv 






1^ 




N 


h- 












O UJ to 


u 


> 








CD 




Z 


to 


z 














UI 












> 






I ni u uj cc uj u 


UJ 


r 


z 




Z 


UJ 


z 


o 


UI 


o 










UJ 














O 


CL 






i - ui z d J < to a 


z 


o 


o 




o 


X 


o 


i-i 


-J 


t— 1 




> 






z 






CD 








UJ 


O 






1 JZ O JOZ *-> 








CC 


1—1 


a 




»- 




CD 




to 




o 






1- 


O 








z 


o 






1 < <UJX JO < CD 


co 


K 


i-i 


CD 


< 


\- 


< 


u 


»— < 


CO 


0. 




UJ 


(_> 






_J 


O 








CD 






I mq wuz Jy-Eio 


o 


U 


< 


i—i 




< 


cc 


Z 


(J 




o 




z 


o 




CO 


U 


UJ 






z 


o 






1 a. Ill X O > < CD «-> UJ _J 


UI 




a. 


> 


X 


cc 


UJ 


o 


X 


X 


• 






cc 








z 


Z 




o 








i d _j cj cc cc uj < ~ « cc 


(J 


X 


or 


ui 


»— « 


Z 


UJ 


a. 


cc 


UJ 




03 


> 








K 


< 




o 




1—1 


< 






i cd > > < a. < o _i > a. 




u 


t- 


cc 


O 


> 


CL 


o 


m 








to 


o 






< 


-J 


cc 


1 


O 


1- 


CC 






icxize jzsuui j 


< 


< 


CO 






CC 


o 






_l 


o 


_) 


OL 


cc 


t_> 




CC 






1- 


z 


< 


o 


> 




i < z o o »- x > t- tr cc < 




cc 


z 


_i 


> 


< 




_i 


l- 


< 


cc 


< 


o 


a 






UI 


K 


< 


< 




cc 


I 


a 




ir>KH Q O CC CO UJ 




t- 


o 


< 


CC 




-1 


< 


u 


•-4 


CD 


t— » 


1-4 




(- 


> 


u 


cn 


CL 




_l 


UI 




o 








«J 


UJ 


UJ 




< 


UJ 




I 




X 


00 


X 


CO 




< 




UJ 


1-1 




a. 




u 




1 l-<tUJUJZ<Cc_JU.ru.Z 


CO 




UJ 


i 


Z 


I 


UJ 


X 


CC 


o 


u. 


U 




a 


o 




-1 


u. 


CC 


_l 


U. 


o 


< 


cn 




1 (D JQQ>Uh O > 






cr 


u 




o 


cs 


o 


1- 


z 


o 


z 


o 




z 


< 










O 




CC 


o 




l> HEKltDlL J»- JKIk 






< 


_) 


< 


z 


< 


CO 


o 




o 


z 


_i 


o 


_i 


-I 


_i 


-J 


_l 




_i 


D 


z 




I ot-»-o<uui04tn<< 






_i 


cc 


< 


cc 


> 


cc 


UJ 


cc 


z 


cc 




< 


< 


a. 


< 


< 


< 


< 


UJ 


<: 


UJ 






1 ul-U J<Q UJ O UJ -J < 




< 


K 


UJ 


(- 


cc 


K 


o 


m 


o 


CD 


_l 


i-t 


1-1 


o 








t— 1 


cc 




_l 


t- 




• x Z> O CC UJOOO 


UJ 




UJ 




o 




< 








»— « 






X 


a 


<_> 


I 


X 


I 


I 


D 


I 




cn 




1 ZE J JtDh JCZZZKI 


to 


I 


cc 


z 


to 


-J 


cc 


— 1 


cc 


CO 


CC 


CC 


u 




< 


o 


o 


u 


u 


H 


u 


CD 


< 




i >- »- o < < o > > > ui o 






UJ 


> 






UJ 


< 


UJ 


1— » 


UJ 


UJ 


z 


o 




Z 


z 


z 


z 


<_> 


z 


z 






1 K0)muuZU)-CKEX< 


> 


< 


I 


CC 


CO 


I 


I 


u 


X 


o 


I 


X 


o 


z 


o 


o 


o 


o 


o 


Z 


o 


< 


Q 




1 <UJQ.OZ»-OD<<<»- 


cc 


u 




(- 


< 


> 


t- 


t- 


o 


>- 


z 




1- 


a 


D 


i 


cc 


CC 


cc 


cc 




cc 


CC 


U 




1 JQUJ>-OJU)JJJOI- 


cc 


t- 


o 


_l 


-I 


a 


o 


_) 


a 


*-l 


o 


o 


m 


-J 




CO 


m 


CO 


m 


a. 


pa 


h- 


r 




i o- — cm eh cm n * o- c> 


<• 


r> 


o- 




CM 


CD 


th 








r» 


N 


CD 


O 






CM 


CD 


CM 


n 


CO 




m 














O 


0- 


Ch 


o 




o 


(M 


CM 


CM 


CM 


n 


«r 






O 


o- 


o- 


CM 


CM 




















— -i 


r* 


r>j 


o 


n 


n 


o 


n 


n 


o 


n 


n 


n 


n 


n 


<* 






i nooooonnnonoo 


n 


n 


o 


o 


n 


n 


n 


o 


n 


n 


n 


n 


O 


n 


n 


n 


n 


n 


o 


n 


n 


n 


n 





s a 




•> D 




c 

a. . 
m 

» **■* 
« i* 


Q 


• e 




(■ (• 




3 -O 








• u. 




u 




o . 




t- c 




ft. » 




« 








o & 




c o 




— • 




Z Z 




ft 








o 


1 C 


a 


1 o 


Q 




r 


1 4» 




1 & 




| >w4 


u 


t f» 


CM 


1 u 




1 » 


O 


1 » 


CC 


1 Q 


a 






1 « 




1 * 








1 x 




1 a> 




1 C 




1 UI 




1 "O 




1 • 




1 4* 




I m 


• 


l •** 




l > 


• 


l • 


O 


1 (> 


c 


1 JS 




1 j> 


« 


1 < 






Q 


1 < 




1 X 




i a. 


« 


1 u 


a 








u 




c 






i m 




i "o 


a. 


1 o 








U 05 
tj 111 O X 

uzz< 

Z K 

H Z Z X 
huuji- 

z o o o 
o < < r 

Z 3 
3 h h jlj 
Ui x x Z 
ZUUL 
ft. 

.. to 
© a a z 
« z z ui 

JOO)- 
X u o 
a h 
« ft. a z 

JO01O 
O UI UI ft. 

to as ae co 



to 

O CO 

a 

X ei 

< U. 
EC 

Q Z 

□ ft. 

Sz 
g« 

ft. u. 

z 



□ CO 
ft. o 
tO ft. 



CD 

«-> CO 
CO 

O CO 

z o 

UI UI 

i— a 
o « 
C CD 
ft.g 

Si* 

dz 

-i a. 

4 

O 

-J 

3 O 
ft. « 



X 

H CD 

£^ 

tC -I 

o o 
>-> tu 
z > 

tc < 

h 

UI CC 

> n 
_l ~" 
< u. 

z o 

=JS 
ft. « 



U CO 

UI □ 

z z 

> > 

X X < 

I— f- « 

< < z 

ft. ft. o 

o o z 

Z Z 3 
OOIU 

z z z 

D D ft. 

z'z'o 

a. Q. m 

_J _l < 

o o z 

u ui 5 

> > UI 
J J z 

< < tc 



CD 

« CO 

a « 

Q 

o 

Z X 
D I- 
-I o 

CO z 

to 

o > 

tC -I 

Ui o 

dl 

CD M 

H O 

CO z 
> n 

CO -I 



J U CO 

M M M 

x -i a 

ft. ft. 

O Z CO 

Z O D 

«yl 

CO <J 

o > z 

> K as 

ae co 

< o < 

2 w yj 

Oil 

z u <j 

_l < < 

5 cc tt 

a. t- »- 



o 

Ui z 

z o 
< 
ui tc 
CO x 

< ft. 

UI < 
CD *~* 
« Q 

co a 

Z Z CD 

m m ac 

hl-IU 
CD CO O 

< < tr 

W M Q 

Q Q CD 

ixj m m 
z z a 



u co 

HI o 

z z 



Z CO 

o □ 

< z 
tr 

X z 

ft. tc 

< o 
o -« z 

Q a: 
to o 

OUII- 

»- « < 



CO CO 

< < 

UI Ui 
CO CO 



z z 

Ui UI 



CO CD 

> > 

CD CD 



ft. ft. 

CO CO 

Ui Ui 

tc c 



itz 

ui o to 

X Z UI 
m <i m 



fv CD Ch 

nnnonoiA 



CD 


© 




CM 


n 


(D 0> 




CM 


CD 


n o 


*4 


cm n 


f CD 


Ch CD 


o 
o o 


cm m 








-0 




IN 


N 


N- 


CD &■ 




0> Ch 


Ch 0> 


th * 


-o < 






















«-« 








m cd 




m 


r> 








n 


ID 


mi 


in r» 


m 




r> if) 


r> n 






m « *> ni o — CD 0> — O •< r» n t o u : j; ^ s. r * x 

SwSS8onnnBKNN0'n-------<<<<mtDm 





O ~ 






0" CM 


H Q r( O H 


m 


o o 


CM * 


* » -0 «o o o 


o 


NO — 




•O <0 -0 -0 CD CD 


CD 


CD (h 0* 


CM CM 


* * * * «* «J- 


f 


* «• * 



ooo-"CMC")*m>o 



310 




no> O — NO — CM 

(D0DOOOOOOx^«'<'>i 
00 00 AO OP 03 00 00 00 CP CP GO 00 OB 



— O — D> CM CM 

o-wninno-ooHoos 

CM(MCMCMCMrM*»a5«t»«r*a5 

<i<io<jooM^onnnr)fi 

003000000030*0*0*0*0*0^ 



z 

tu 
uj a. 

03 O 

Si 

O 3 

1 z 
£ ae 

3 UJ 
Z (- 

cr in 

UJ 



U.HI-2 

o cn tn o 

Hi I h H 

ar u 4 4 

3 u cj 
HJOO 

O — -J _) 

4 < tn m 
ac _i •— > ■— * 

U. U. Q Q 



03 -1 

S3 

1-4 

Z _J 
(OKU 

n uj o 

•-it- z 
OC O OC 
UJ 

O fe 03 

z z z 

l-< w »— 

4 4 4 

a: a: a: 
a. a. a. 

CD CO CD 



a 

Q Q UJ 
UJ UJ CD 
CD 01 O 

□ a _j 

J JU 
U O I 
I I 0) 
0) on 03 

Q C! 

z oc oc 
a ui o 

hZ3 
irOK 

Ul UJ UI 
a: cr or 
3 3 3 
hhh 
u u u 
< < 4 
cr or tr 
u. u. u. 



03 UJ Ui 
□ CD CD 
JOO 
U _J -I 
I U CJ 
CO I I 
03 CD CD 
M 03 03 

CNN 

oc cr 

UJ 

ui cr ui 
cr 3 > 
I o »- 
i- u. u. 

UJ UI UI 
cr cr cr 

? 3 ? 
o o u 
< 4 < 
cr cr cr 
u. u. u. 



a cd a 

ui o uj a 

CD _l CD ui 

O CJ O 05 

J I J O 

OfflU J 

I B I U 

CD *-> 03 I 

03 CT — CD 

M OC O 

cr z z 

UI UJ 

x > cr co 

M UI Q 03 

CO CD £ m 

V OC 
UI UJ t- 

cr cr I H 
3 3 a> J 
H »- « 3 

U U U I 

< 4 

tr ac x x 
u. u. u. u. 



Z 
UI 
Z 0. 
Z Z UI o 

ui ui a. i 
a. a. o cd 

o I 03 

1 I 05 **> 

05 03 00 DC 

O M M 

Z oc oc ui 

UI 

03 UI O OC 
« Z 3 I 
OC O H H 

Ul UI UI UI 

oc oc cr or 

3 3 3 3 
hKHh 
CJ CJ CJ CJ 

4 4 4 4 
or or or or 
u. u. u. u. 



z z 

UJ UJ 

a. a. 
□ o 

i i 

CD 05 
03 03 



z 

UI 

z a. 

ui o 
a. i 

CD 

1 03 
CD 

m oc 



or oc ti 



oc UJ 
3 > 

a -> 
u. u. 

ui ui 
or or 
3 3 
H H 
U CJ 
< 4 

or or 
u. u. 



or Z. 

UJ 
x > 

M UJ 

03 CD 

UI UI 
OC OC 

3 3 
h- t- 
u cj 

4 4 
or or 
u. u. 



03 

z o 

UJ. _l 

a. z u 

□ UJ I 
i o. £ 

CD O 3 
03 I Z 
« CD or 

OC O UI 
Z K 

03 

CD 

2fe 

oc 

UJ 
or 

_ 3 

M Jh 

Ul £ cj 
4 

X X oc 

u. u. u. 



— — o — o — cm n * « *o r*- ofr o — cm n «■ in >o r*. o o* 

NNOOCDCDCDrvNNNNr^f^NNN £*>*- EiCtElSSsSSfcESCi 
C003 OOOOO0}C0mOOOOOOOOOOOOOOOOOO 




> o 
— to to UI 

< UMU 
K JZBO 

ui 5 or 

Q.KZI-1 

o h o o 

2 <-• D O 

>Ot-0£< 

Q U < t- — 
O K (D Q 
od ui u 

OLUU 
UOIOLL 

(dzoiiz 

< UI UI > > 

> I > J -i 




o o u 

UI UI UI 



CD 


CM O 




P) 0* 




OS 


ft- 






CM 




Of 0- 


00 




o 








* «■ 




* «■ 






o> 


o 


o 


n 




P) 


pj n 


n 


n 


n 















> 


>■ 


Ui 














0) 




5 


X 


O 




X 


a. 


UI 




> 


Ui 


»- 




o 


< 


UI 


< 




o 




09 


_J 


U 


t- 


1- 


u 


O 


PC 


< 


< 


z 






o 


<j 


(J 




< 




a. 


u 




h 


UI 


1 


Ui 


Ui 




o 




Ui 




> 




z 


ui 




1- 


(0 




1- 


or 


i- 




CO 


o 


z 


co 


w 




»- 


1 




co 






00 


o 


o 


o 


X 


(J) 


Ui 


UI 


UI 








m 






u 




© 


o 


X 




cti 


Ui 




III 

Ui 


III 
Ui 








<i 








O 


ui 


o 


o 


o 


<J 




u 


1 


n 


as 


< 


O 


< 


< 


1- 


1 


o 




z 






u 


< 


o 












o 


UI 


UJ 










l- 


=> 


X 


0) 




o 


o 


H 




1- 




u. 


a) 




Ui 


»- 


< 


< 


0) 




CD 


05 


< 




e» 


X 


< 


u 


u 


UI 




UJ 


UJ 


or 




z 


o 


X 






X 


H! 


X 


X 


o 


8 


_i 






*- 


»- 


u 




u 


u 








a 


u. 


CD 


01 




u 






UI 




UJ 


Ui 








u 




X 




z 


QT 


z 


X 


t- 


X 


X 


X 


X 




O 


o 


Ui 


o 


K 


z 


o 


u 


UI 


ui 


o 


1- 




a. 


OD 


o 


to* 
























n 




o 




OD 


0* 


o 




o 




IT) 


N 


N 




N 


N 




OD 


OD 


00 




ai 


N 






N 


N 




N 








N 












> > 








o 


a. (0 








UI 


o a. 








z 


u o 










CD 


UI 






z 


o a 


z 


z 




o 


o 




o 






< -I 


oe 


1-4 


o 




cc < 






z 


< 


o > z 


< 


< 


O 


or 


IQ.H 




o 


-I 


UI 


hOt- 


UI 


i-i 




OL 


(J CD 


or 


.J 


U. 


Q 


< CD « 






o 




C£ o 


_J 


_) 




-1 


z> z o 


< 


< 


UI 


< 


m m ui 






or 






X 


X 


z> 


X 


a. co 


u 


o 


1- 


u 


cd < or 


z 


z 


u 


z 


Z M uj 


o 


o 


z 


o 


<t Q X 


cc 


or 


3> 


or 


or ui K 


03 


00 


a. 


a> 


i- r o 



— a-^W »-CMP)*O-P)*IO0 k -<tMDDff' »>N0D&'«'»*Na)(MO0D^t , »IO 

nnnnnonnonononnnonnnnnoonnnnnnonnnn 





(M 


CD 


(M 


n 


CD 


- N -0 




«r 


• 


0- 


0^ 


o> 


ry cm cm 


n 


o 


n 


n 


n 


pj 




o 


n 


n 


n 


P) 


n 


n n P) 



m 

f- 
m 
u 
c 
m 
o 



u 

o 

u 

<L 

(- 
O 

c 



a. 




OD 


o 




o 




01 


n 


v4 


01 


00 






CD 


0* 




rs 








N 














m 




r> 


ft 








0- 


0* 






n 


n 


n 


n 


n 


P) 


n 


















m 


01 


OJ 


01 


01 


Oi 


01 


01 



ON 




o 




< 


< 










u 




-1 




£ 


8 

z 


ae 




u 


CD 
i 


5 

z 


M 


NE 












UJ 


UJ 






M 


H- 






Ui 




o 


o 


-i 


-J 






H 


0) 


E 




03 


UJ 


z 


z 


a. 


a. 




< 


(0 


< 






o 


m 


=> 








< 




< 




§ 




-1 


o 


-1 


-1 


-J 


-i 


a: 






o 








-i 




>s 


< 


< 


D 


UI 


Q 






1- 


OJ 




I 


I 


»- 


ct 


UJ 


_l 


UJ 


r 


tD 


03 


-1 


te. 


o 


o 


UI 


UJ 


-j 


a. 


E 




< 


< 


a 


UJ 


z 


z 


M 


u 


a. 






H 






o 


3 


o 


o 


tr 


OJ 




-I 




0) 


O 


a 


ii 


O 


cr 


tr 


< 




_J 


a. 


Z 


o 


UJ 


UJ 


E 


-1 


a 


n 


a. 


> 




o 


< 


a. 


E 


E 


O 


o 


O 


O 


o 


o 




£ 


O 


o 


O 


O 


UJ 


UJ 


UJ 


UJ 


UJ 


UJ 






UI 


UJ 


UJ 


UI 


z 


z 


z 


z 


z 


z 


o 


o 


z 


z 


z 


z 














i— t 


t-l 












—J 


-I 


_j 


_J 


_J 


_i 


_l 


_l 


_l 




_J 


< 


<£ 


< 


< 


< 


< 


< 


< 


< 


<I 




< 


r 


e 


e 


r 


E 


e 


e 


r 


E 


e 


E 


E 



oom»r>QDo>o — o £ n n o a* 
0l0JOlMOl^lOl^nnt , )**** 



313 



> 

CO u 

m x 
< 

_l OC 
< O 

z z 



is 

Q O 

UJ Ul 

e s 

oc oc 

2 2 















u 


< 


OC 










IE 






u 


1 


z 


2 
2 


PA 




NE 


M 

!= 


WAN 


J 

a. 


RE 




NO 


ERA 


M 


u 


> 




c=a 


& 


1- 


o 


5= 




£= 


O 


05 






5 


«£ 




<€ 


z 






OS 


> 


Ml 


o 




J 


Ui 


Q 


Q 






2 


a. 


Q 


Ul 


= 


U. 




o 


■ 


£ 


€A 


g 


102 


u 


OC 


u 








M 


2 


O 


Si 


go 


OC 


u 




& 




5 




< 


s 


o. 


2 


t= 


< 


oe 


U 




2 






o 


05 


x 


U 


Ul 


2 


z 


< 


Q 


© 


EL 


3 




> 




otiia.lL 

£ (0 £ Z 
Ul Ul > > 
I>JJ 



u u 

X X 
Ul Ul 



















Ui 






o 






05 




£ 








05 


1- 


« 


> 


Ul 


1- 




§ 


< 


Ui 




o 


Ul 




=J 


u 






© 


o 


o 


2 


z 






© 


U 


© 




< 


2 


l_ 




& 


yj 


t 


2! 




»- 


© 


[=0 


(0 


> 






Ui 


1= 


\- 


05 






o 




03 




z 


0) 


05 


Ul 




Ul 




a 




iS 


o 


o 


O 


X 


05 


2 


© 








(Si 






© 




<€ 




z 




Ul 




Ul 


Ul 




X 


o 


Ul 


a 




© 


Ul 


© 


© 


o 


u 




3 




§ 




S3 


< 


< 




1 


t- 










<€ 


© 


© 




s- 


05 


Ul 


Ul 


Ul 




u 






(= 


D 




© 


© 


o 


1- 




1- 




u 


05 




•€ 


< 


< 


05 




en 


03 


-s 


U 




u 


u 


Ul 


05 


Ul 


2 


m 


t— 










I 


Ul 


s 


I 


o 


0) 


0E 


1- 


t- 




u 


X 


© 


U 




o 


UJ 


05 


2 


05 




© 






Ul 




2 


!H 


Ul 


Ul 


o 




X 




z 


K 






I 


X 


X 


X 


;= 


O 


o 


Ul 


O 




o 


o 


Ul 


Ul 


O 




© 





x c Ul 

< M O 

oc < < 

OO. u 
X Ul 

»- 0C H 

I 05 

Ul Ul Ul 

O © X 

Z < © 

XU I 

U Z 

o 

2 03 « 
K Ul K 
© X < 
Z u x 
_) ~ 
0C u 
Ul Ul 

ea o « 



4) 


03 O- 






n 


0- 




00 


t> 




Or 


OJ 










9- 


to 


8* 


o» 




















o 


0* 


© 


O 


n 


r> C5 


n 


n 


o 


n 


o 


n 


o 







~ m n <r o r* n * o* — ~ — ~ — — — ~ — — — 
mnniNNr)>0'0<04<io«oi( i )«<OMiihOxn«i) 

OOOOOOOOOOOSSNNNSNNMDOtDIDIS 









u 




00 












O > 








10 




2 


2 


2 








u 


Ui 










> 




u 










2 














2 




2 


Ul 


2 


2 


yj 


2 








2 


OC 








U 


a, 




2 






2 


l 




■2 


2 






OE 




2 




C 


2 


O 




_l 






> 




2 


D 


m 






Ui 


D 




2 








© 




2 


2 


1 








M 


E 






t=i 






CD 




03 


u 




h- 


o 






2 


u 










<€ 


U) 


s< 




J 






i: 


05 05 


H 




£0 


2 


(- 




o 




03 


0. 


Ul 


U 


Z> 


_j 


o 






03 




00 








u 


2 


_J 


y 




e 


a. 


O Q 




< 






< 


2 


2 


u 




a 


z 


2 


03 


u 


yj 




Z 


O 










Z 


o 


> 


2 




(0 




2 


-1 Ul 


2' 


2 


> 


X 


K 


2 




X 


2 






6K 






2 


2 


O 


u 




J 








IK 


DE 


Ul 


€ 


M 


2 


2 


U X 


S 


ui 




2 


Ul 


a. 


e 


Ul 


U 


E , 


> o 


2 


1- 


< 




2 




< 






> 


> 


<s 


s= 


< 





2 


> 


OL 




u 


(_ 


EC 


e 


> 


s, 


2 


n 




2 




03 O 




< 


_l 


ti 




© t- 


cs: 




X 




3 


ss 




2 


2 


2 


Ul 


2 


J 


< < 


2 








□ 






J 


D 


-i 


a. oc 


U 


OC 


3 






Z < 


O 


> 






Q 


[= 


X 




> 


[= 


OE 


2 


2 




2 


-1 


> 


2 




_J 


£- 


2 


OC 




o a 




Ul 




5 


2 


=> OC 


2 


a. 


I 




1- 




« 


ts 


cs 


2 






Ul 




= 


2 




2 


2 


2 


O 




S3 




M 


6- 


> o 


03 


o> 


© 


-I Ul 




o 




u 




X 




2 


2 




> 




2 


»- 


U 


Ul 






2 


2 


2 


X 




2 


BB X 


C0 


H < 


M 




•-a 


0. 




u 


2 




y 


2 




2 


2 


2 


2 


ii 


2 


05 U 


2 


2 


z 


2 


Ul 


2 


2 


•J 


U. 




Q 


: 


03 _J 


U 


2 


_J 


u o 


« 


03 


j 


e. 


e 


> 


2 


t= 






2 




> 


— o 


OC 






ry 


© 






2 


D 


2 


O 


2 


< 








o 


E 


2 




[=: 


is 




2 


83 


U 


2 


!= 


2 


K 


u 




2 


_J 


2 


2 


€ 




2 




O 




2 


_J _l 




_J 


_l 


_l 


D 


2 








•s 




2 


o 


2 


2 


2 


2 


z 


_l 


2 


*: 


K 


> 


m 


UJ 


DC 


2 


CE 


54 


2 


a < 


< 


2 


2 


Ul < 


UJ 










J 


2 


tS; 




Eii 


O 


Ul 


J 


< o 


2 


2 


Ul 


t= 


0E 


i= 


Q 


a 


2: 


(53 


_j >- 




o « 




t=5i 




OC « 


_) 


H 




o 










UJ 


& 




c 






2 








2 








1-4 




X 


2 


(J X 


X 


Z 


X 


n x 


a. 


03 




J 


J 


E9 


!= 


J 


s 


2 




2 


OE 


X 05 


2 


OE 


z 


W 


J 


DC 


2 


e 


cn 


OC 


IT U 




< u 


u 


u 


U 


i- © 


03 


< 


;'=• 


>3 








2 


z 


> 


2 


> 


yj 


O « 




Ul 


> 






2 


<« 


UJ 






Ul z 


© 


QC 2 


2 


2 


2 


U 2 


2 




00 




U 




2 




£- 


a. 


SI 


e 


2 


< > 


2 


2 


oc 


J: 




2 


(J 


2 


u 


X 


X o 


2 


O □ 


O 


O 


O 


2 D 


< 


Q 


L ! 


e= 


o 




t= 


2. 


2 


2 


■2 


2 


!- 


K Ul 


S 


h» 


2 


> 


i= 


H 


O 


t- 






K OC 


; 


X QC 


E 


ee 


E£ 


3 ee 




UJ 


e 




5- 




O 


J 


2 


=! 


2 


_J 


□ 


»- K 


;=-- 


O 


J 


-1 


O 


□ 


_) 


O 




o 


O 03 


2 


1- 03 


ra 


•a 


ffl 


0> CO 


1- 


£ 



— - 


2 












p4 


W 


n 


2 


2 


P) «r 




2 




OJ 


2 










m 


N CO 


0* 




Oi 


03 


OJ 


P3 03 


»-< 


w 


© 


2 




2 


2 






2 


2 


2 


2 


2 


N N 


is. 


f- 


9- 


2 




& 


o 




© 


O) 


Ol Oi 


r>j 


C3 * 




if 




0- 0- 


O) 


OJ 




1 


o 


; 














«h 


















OS 


OJ 




n 


n n 


P3 


to n 


n 


C3 


C3 


n n 






n 


2 


n 


2 


o 


n 


n 


P3 


n 


P) 


2 


n 


n n 


n 


n 




P) 


n 


t*> 




n 


n 


P5 


n n 


P3 


n n 


n 


n 




n n 


T3 





u 

00 



c 
o 
■ 

3 

c 

0. 



4* 

u 

« 

ffi 

. ui 

* a. 

u 

3 -D 
•O C 



o . 
t- . 
a. a 

o . 

c o 
r o 



XI 

o 

u 



o 

or 

Q 



9 

a 



0. 




mm 



00 OB CD OB 08 



££«»«pB»eocoooea»««oBOBeoeoeo 



z 

3C X X K 
Z 2 Q X Q CD 

< 5 a ui 

X O Oh 
UECI-I- 

< o _i tn z 

X N4 3 i-i K 
ZUIUIO 

II I I II 
»—*—•—»—►—»— 
uuuuuu 

UI UI 111 UJ UI ID 

I-I M M M l-l i-i 

1 I Z I I I 
UUUUUU 
222222 
O O O O O O 

08 00 00 00 00 00 

08 00 CO n a 00 



z 

S X 

z z a x 

"u < 5 a 
ui x o 

IL 111 £ E h 
(I) < U _l 
Z O X ►* 3 
32U2U 
I I I I I 
< < < < < 

ft HH l-H M »•< 

2 2 2 2 2 

o o o o o 
z z z z z 

3 3 3 3 3 
UI UJ UI UI UI 
2 Z 2 2 2 

a. a. a. a. a. 



x K 
q tn 
ui 

O K 



_l 03 Z 



Z O 
I I 
< < 
—i i-i 
Z 2 

o o 

UI UI 
2 2 
0. Q. 



U < 

UI x 
£L UJ 

tn 

2 o 

3 2 

I I 

X X 

< < 

cc tr 

o o 

z z 



Z x 

* a 
z 

3 O 

a 
Z u 
< -i 
x Z 

Ui I 
I x 

X < 

tr or 
o o 
z z 



o o o o 

UI UI UJ UJ 
2 2 2 2 

a. a. a, a. 



0800080808030000000300 



111=1 SS6aSSHS3SSS«m3UsSESS2335S*3Jf£SS 

?<"><"> SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSiisii 




X K 

X Q cn Z 2 



Q U| 

□ 



< * 

x Z 
UI 3 



2^2-2- 



_ 08 
-I UJ 

< z 

CD < 



zzzzzzzzz 



>->>>>>>oooo 

CltltttltCZZZZ 
<<«<<r<<3333 
ZCZZZCZ-J-J-I.J 



X 

Q x 
Q 

o 

a. k 

u _J 

~ 3 

Z U 

I I 

or or 

< < 

_i _i 

3 3 

q a 

o o 

z z 



00000 

z z z z z z z 

3 3 3 3 3 3 3 

_l _J _) _J -I _J _l 



_l CD Z 

3 « H O Z 

U I O 2 < 

I I I I x 

or or cc or ui 

h* H H < I 

I I I — ( — I 

m 3 3 

U U. U. Q Q 

z z z o o 

-> <-> « z z 



a.a.a.a.OLQ.a.a.a.a.o.o.a.OLLa.o.o.ao.o.o.o.cLa.cLCLa.t-1-KHHHHHHi-H 



w oxnintnjOxnntD'OOHnintnooxNnvn'OOx c\in*m'0-*n<n«i- 

N<OQOOQQO r, ' l " , ' < ' ,-- (I)0DII)00IIIDB)l>'f0'tt'Q'0'0'OOOOOOO«»»' < ' < 
H'OOOOOOOOOOOOOOOOOOOOOOOOOOOOO-' — •« 

§000000000000000000000000000000000 



315 



Ui I 

• I c 

a. i o 

■o I *» 

e i a 

m i — 

l k 

. I u 

1 m 

a i • 

■ i o 
a. I 

. i f 

□ I m 

. I — 
U I 



I — 
I > 
I • 



H 

3 5 
• e 

c { 
o. 5 



u 

m 

SB 



u 
o 
(. 

0. 

f. 
o 
c 



CL 

o 

8 



o 
o 

s 



11 

0. 



© 



— 4 
u 

Q 



8 



< < 



















< 






o 


z 










Z 


X 




X 


1- 




RI 




> 


3 












1 


a 


X 




03 




UJ 


e» 


s 


UJ 








u 


< 






a 




UJ 




h- 


z 


o 


z 




UJ 




Ui 


X 




o 




e 


t= 


X 


u 


3 




0. 


z 1 


z 




a. 


UI 


AM 


CR 


K 


ST 


s 


< 


< 

OB 


-1 


o 


CO 


0. 


0, 








X 






M 


t~ 




o 


u, 


o 




09 


CO 


03 


i 


1 


UJ 

1 


r 

i 


o 
i 


X 

1 


o 
1 


NT 


YC 


o 




o 


3 
Q 


—1 


CO 


u 


u 


CJ 


u 


u 


a 




< 


£ 


CO 










< 


£ 


UJ 


u 




UJ 


UI 








M 




e 


£ 








z 


z 


g 


z 


z 




RY 


RY 


AS 




AS 


m 
< 


m 
< 


H I 


o 


OB 


SB 


m 


03 


m 


CB 


< 


< 


(OH 


> 


J 








I— 


1- 


(- 


t- 




t- 




Z 

i 


Z 

£ 


ID 


AR 


OP 


OP 


OP 




o. 


0. 


a. 


a. 


0. 


o. 


0. 






o 


£ 


(- 




K 


< 


£0 


03 


CD 


0) 


to 


(0 


05 






z 


M 


CO 


n 


03 




UJ 


UJ 


UJ 


UJ 


UI 


UJ 


UI 






< 


0T 






m 


* 


OS 


OS 


OS 


or 


ac 


OB 


or 


a. 


a. 


u 


GL 


2 


i 


z 


a. 




o o 

WHO. 











< 








CO 


z 




<E 






< 




(J 


CO 


(J 




o 








< 




z 


UJ 


o 


UJ 


Q 


3 




Z 


< 




z 




z 


z 


z 




□ 




o 




z 












-1 




X 


£ 


z 


o 


3 


< 


< 


£ 


U 




< 


3 




£ 


3 


UJ 






CO 


z 


a. 


EC 






3 




z 


NO 




M 




o 


X 




3 


UJ 




0. 




z 




o 


h- 


0. 




z 


a. 




£ 


£ 


< 


o 


I 


Z 




z 1 


a 






3 


3 


o 


UJ 


3 


< 


UJ 


CL 




-J 




UJ 


UJ 


or 


£ 






< 






< 


(J 


z 


z 


O 


O 


Z 


Z 


M 






o 
u 




a, 


a, 




> 


M 






ON 


z 

s 


CO 


u 
o 


_j 

4 


TV 


< 


o 


< 


< 




£ 


o 


-J 


M 


M 


z 




Z 


z 


UJ 


O 


-1 


t- 


> 


QC 


oc 






□ 


o 


z 

0. 


an 


z 


a. 

UJ 


PH 


UJ 


UJ 

t- 


i 

3 




£ 

3 






UJ 




0T 


< 




u 








I 




CO 








< 


< 


z 1 


z 1 








0. 


X 


0) 


03 


SB 


00 


a. 


a. 


a. 


a. 








CM 


n 


















tn 


n 












s 


CD 


CD 


CD 


CD 


CD 






o 




o 


o 




0* 


CM 


«^ 


«r n 


o 


*H 


cm 


CM 


cm 


CM 


CM 


CM 




CM 




CM 


• 


r> 




n 




CM 


o <o 


N 


















CM 


n 












CM 


CM 


n n 


n 




o 


o 


o 


O 


O 


O 


© 


O 


© 






z=i 








~* 




VH 





a. a. a. 







z 












X 




C 1 


E 


i 


© 


X 


U I 


< 


3 




Q 




X 




O 






U 


£ 


or 


H 


• I 




4 


u 




4* 1 




X 






m 


s 


UJ 


£ 


o 




1 


1 




1 


> 1 


> 


> 


> 


> 


• 


CO 


CO 


CO 


CO 


«- 1 




[=1 




>-c 


JS 




or 


or 


or 


<o 




3 


3 


3 


< 1 


UJ 


UJ 


UJ 


UJ 




-J 


=J 


-J 


-J 


< 


a. 


a. 


OL 


a. 


X 


00 


00 


00 


00 


U 














CM 


n 


* 


• 


o 


O 


o 


O 




CM 


CM 


CM 


CM 


O 1 








*4 


o 


o 


O 


o 


O 




z 

^ x 
Z Q x 

3 a 

o 
£ or H 

< O _l 

x i-i 3 
UI £ U 
I I I 
03 03 03 
O O O 

z z z 



>> as oo oo 

or or t- H »- 
< < 

z z z z z 

o o o o o 

£ £ £ £ £ 

I I I I 

3 3 3 3 

a. a. a. a. o> 



a en 

UJ 
o (- 
t- o 
03 X UJ 

M(-l 

X O 03 
> I z 
03 CO 3 
O O I 

z z > 

0) 

00 00 m 

H k or 
3 

Z Z UJ 
O O _l 
£ £ a. 
-J —J 

3 3 00 

a. a. i- 



316 



CD 

I 
IL 
Ul 

"S. U 



(0 

o. to 
u 
»- o 

U CD 
< 00 

m < 



ui > 

CD Z 
0. 0. 

< z 

-I Ui 



> I- 

Z CD 

5 ar 

Z LU 

a. «-• 



CD CD 

> z 
z « 

0. (J 
Z Z Ui 
Ul ^ Z 

> 0. Ui 

SzS 

I- D UJ 
< < CO 
OKh 
2 S— Q 
Ul 

z to z 

5 O 3 
UC.J 



-i 

(J 

> -I 
u 

I- CD 
Z CO 

Z Ui 

o o 

u « 



m 

9 



> > 

u o z r 
z < < 

y > 

z _i > > 
O < £c cr 

KIOO 
BQhH 
Z < < 

z < oe oe 

Ui MM 

O O 0. 0. 

gZ CD CD 
D Ul Ui 
UJKC 



1 

_l 

•s. 

Ul < 

-1 o 

M < 

< tr 

U. I- 
>- H X 

te co z 

gas 

< o -e 

K -I 

0. M Z 

CD < K 

ui -i 5 

ELD) 



CD 
> 
CD 



EL 
CD 
Ul 
£E 
I 

Z U 

CD — 



s 

M M J 

oo a o 
z z u 

Ul ui 

o 

tCKK 

M < 3 
< u. to 



O — 0- 

MnntOCDCDCDCDCDLCDODCOCDCDCDIhNNCDCDN 



z z 

P t Z I- 
to to z < 

< < H Z 

CD Z 
K (0 < H 

O -to 

HK0)< 
DO 

^ H CO 
O CD < 3 (0 
V ►-»->-" 
3 3 CD < CO 
I- < 

< < O CO t- 
f z v u 
XZ33UI 
Fh •-« 
CD CD < < Z 

<< ii^ 

l-l-Kt-O 

z z to co at 

MM<<0 



O i H f 





CO < M 
M M Q 

H Q < < 
m < 0C -1 < 
K 5 _J 

i- i- 5 

_h\(Dh 
3SQHO 
Ui Q U. m 

2 Ik u. 

OL Ui »- I 

hz!m5 
~<r33 

v D & UJ Ul 

on. > > 
<r o. a. 
_ o z z Z 

U. < U 111 Ixl 



o 


o 


*4 


S 


Ch 


N 


m 


QD 


o 


O 


o 


O 






r> 


r> 


r> 


in 





CD 
CO UJ 
ID —I 
-I 

• E -J 
ICS Z -J 

I < - < 
Iff f- 3 

I I in 

i a. < »- 
i < — cn 
i — a w 

1 S3 UJ s 

e u 
u, 

o u 

1 > => => 
,01 K ff 
0. 

O CO CO 
- LU UJ 
(BOO 



z 
o o 
z - 

=> to 
_l - 
o 
U. x 

□ uj 

Z —I 

O < 

» ff 

I- 3 

4 UJ 

<J -I 

— 0. 

C ff 

□ UJ 

(J I 

UJ 

o o 



U 1- 
UJ Z 4 
Z O ff 

UJ 

_l CD CJ 
D UJ 4 
l- J J 
(0 

~ e e 

u. o cs 

4 4 

u c c 
- X I 
U CL CL 
4 4 4 
c — — 

o o o 
I 

K UJ UJ 
10 E 

co - z> 

O O t- 
_J x D 

(J) UJ CD 



111 

3C U 

ff K 4 UJ U 
--EZUI 
4 4 UJ Z 

0. 0. U Z 

UJ UJ 4 O Z 

k ff a. «-» o 



E E 4 
©Off 
4 4 I _ 

m& 

ff ff ~ 

4 4 a 

Q O H 

z 

UJ ff 4 
CO UJ -I 
OIL 

J t; r 

u O »" 



4 »- 
E 4 
UJ E 
UJ 

a, 
□ 

E 

CJ 
4 — 
E O 

1 4 
a. e 
4 O 

- 1 



> 

CD 
Cl 
O 

> 

E a 

o 

t- _j 

O 4 

Q O 
E E 
4 4 

u u 

E E 

UJ UJ 
0. EL 



o 








<J 


Z U 


UJ 4 








4 




> 


cn 


4 


□ UJ 


a — 


to 


z 


E 


CO 


UJ 


E 


< 


—J ff 


— 4 Z 


o z 


o 


□ 




CD 


2 


O 


z 


ff — 


CD > 


Z ff 


z 


to* 


4 


4 






4 


UJ ff 


« 4 CD 


UJ 




»- 


CL 


E 


(J 


u 




ff K 


U U UJ 


K X 


z 


4 


UJ 




z 


UJ 


1= 


to 


x > Z 


ff 


E 


U 


E 


(J 




E 




3 1 


UJ 4 O 


o c 


UJ 


M 




4 




UJ 


UJ 


O 


Z U h 


4 X 


X 


_l 


4 


> — 


-I 


(- 


CD 


K — 


_J UJ K 


— ff 




ff 




e a 


UJ 


E 


UJ 


O _J 


UJ > CJ 4 


E 4 


X 




Z 


O E 


lf> 


4 


E 


UJ 


CO 4 E 


UJ M 


0. 




E 


t- 4 


tn 


Q 




CD > 


CD U. E UJ 


ff a 


4 




UJ 


u u 


u 




mi 


UJ 


UJ Q O tt, 


i 


M 


t- 


2 


UJ 


> 


W 


UJ 


E E 


> X o 


W E 


Q 


4 










CD 


4 


z t- 


Ul — 


1 


E 


Z 


O CD 


u 




CO 


CD > 


uO > 


CO 4 


0, 


CS 


E 


E U 






UJ 


UJ 


i-i*.UJE 


CO ff 


UJ 


4 


UJ 


4 I 


u 




> 


> o 


Ut-DI- 




E 


E 


K 


u w 


4 


4 




4 


4 4 => Z 


o c 




X 


CD 




ff 


E 


E 


E E 


E U J 111 




E 


CL 


4 


E Z 


D 


O 




88 


O — (J 1 


a a 


s 


4 


E 


UJ ff 


X 


X 


s 




I J U 111 


4 CO 






< 


ff □ 










K ff o c 


E 4 




Q 


0. 



ryn^-mtf^r^cDCDtrcDCDCDt^ — ni 





r> 




m 


r> r> 


n t> «• 


rv 


o 








o 




m 


«r r» 


>o n <d n 


n ts. 


CD 


CD 


CD 




CD 


s 


CD 


CD AD 


CD CD CD s 


o m 


n 


n 


n 


n o 


n 


n 


o 


n m 


n n n n 


v r> 




tn 


ID 



COZ >EZUZ H O 

C0DO > E > Ul > O UJ O O UJ UJ >UJE 

3E- Z E □ E u E - Z « >DO ZE E t- D 

E>K O 0> t-040t- K EEZ D 0«Z 

>X4 U KE>C0t-_Jt-4CDW OHD O CO K CD — 

XHE »- Ul UOEOC0 CD u UJ UJ t- 0) J ZO □ »- 

h oco 4Z uikoliojo«juj u d_j uw>m 

li JD K C9Ut-XUJ4UJ_l UJ CS UJ U U. JU UJ4E4 

UOffEC0ZZ>ZUJUUXUJXECSKZZ4OO Z K o — a 

O x>D40E>0UJ4(JXu Z 3 O E ZU.ZUH OKOr 
CD ZUXE_I»0EZ0E4U4BDU_JE0Z300UJZZX0UJE 
OZO t->fft-(-4>Zt-K4ffUJ_IZ 3XO_l »-Z40t-C)E> 
ZO-O XC04(J_JK> hlh J 3L.UJK" 11) h _)« 4 X 
— CO_JU.t-ZEUI 4E-J t- OU JOZ CDU.ff4KffH>CU | - 
> CO — UJ O 4UJCSf-_J44E U. □ EO — O4E — L04EOO 

E - U - U.ECLZE JZELD<JJ> UJ (J _l U 4 Z ff O X U. 
OUXLZOhOXIil —UIO E <Ililll)x2JUO.<Ult-t-ZO 
hXU O KffK_l)-ff UJUJ>»-Ot-t0UJOO4UJffQ-4 O 

U Ul CO — ff CO CO 4 U14C0 UlffC0OZt-UJ« —U_IEHOEZ«> 
UJ J D ID - 3D_JE_IU4EE3>EUJU_IQEt0 OUJCOC,. 
£K<Z-<CI-UO. - "-UIDCOXt-EUJE UJ^-CSOOCSO-Jff—fj. 
>ffK>«Jff>>EXEQQXKOffC0CSinEQX(JKZZZZffOU- 
K0IZWIIUl-0<L)*-3jruu004t-ZD5333xLlZ- 
l-tLhh-KI-KIOUttlQUIUIllDUlJUEO-lDJJJJUir"- 



o - 








n 


0- 


0- 








o 






0" 


o 


n d- 


d- ru n 


*o 


CD CD 


CD 


& 


o 


0- 0- 


0- 


— (M 


n 






ru 






cm ru n * r> -o o» 


— n 




m o- o o 
















O O 


o 


o 






»— < 




ro ru m ru ru m cm 


n n 




n n «»• «!■ 




O O 


o 


O 


O 


o o 


o 


n n 


n 


n 


n 


n 


n 


n 


n n n n n n n 


n n 


n n 


n n n n 


n ; 




319 





c 




o 








*» 


K 


a. 


■I 




t- 


u 


a <t 


u 


■c E 


w 


*> o 


a> 


o *> 


O 


E o. 




3 E 


£ 


a 7 




c in 












- C 


1 c 


W Q 


Ul 


• 


(. in 




3 C 


■I 


V Ol 


1 •*» 


• — 


1 -1 


u 03 




o 


1 > 




1 V 


a c 


1 1- 


m 


1 £ 




1 4 




1 < 


u • 






1 < 


■o m 




m e 


: * 


OC l» 


1 o 


.0 




t» — 




o u. 




• . 


1 • 


» •» 


1 V 




1 • 


SS 


1 u 



© 

2 



m 

© 
or 
p 



z 

Ul z 
Za.ui 
ui o c 

a i o 

□ 03 I 
I ID 03 
03 — OS 

as or — 
«- or 
or z 

Ul Ul 

x > or 
•=• Ul o 
03 CD E 

X. 

Ul Ul K 

c or x 

3 3© 
(■(-« 

U U Ul 

< < 
or or x 

U. ll u. 



03 


z 


z 












O 


UJ 


Q Ul 






SS 






-1 


a. 


Ul 0. 












Z © 


o 


03 O 




03 


-1 


_l 


u 


Ul 1 


i 


O 1 




i 


D 


< 


1 


a. E 


2 


-1 £ 






u 


z 




O 3 




u 2 








or 




1 Z 


As 






§ 


> 


Ul 


s 


U3 or 


or 


£ or 








t- 


3 


O Ul 


Ul 






z 


-J 


03 


2 


Z K 


t= 




w 


or 


u 


o 


or 


0) 


03 


or 03 


m 


UJ 


© 


or 


Ul 


03 




Ul 


M 




2: 


iS 




m u. 


u. 


t- K Z 


or 


© 


or 


2 


© 


— O 


a 


03 03 O 






Ul 


O 




or 




LU m 






H- 


X 


u. 


Ul 


UJ 


IhK 


fe 




03 


u 


o 


or 


or 


CJ 4 4 














3 


(J «J 


s 


z 


Z 


2 


z 


1? 




JOO 












£ u 


o 


"J J 


< 


< 


-€ 


< 


< 


< 


4 


< 03 03 


or 


or 


or 


or 


or 


x or 


or 


_J — - 


£L 


a. 


0. 


a. 


0. 


u. u. 


u. 


u. o a 


03 


03 


03 


W 


03 




£ £ £ 

3 3 5 
< < < 
or or or 



3 
Z 
tr 






w 


(J 03 


EC 




















■« 




Ul o 


z 


£ 




03 














b 

3 




|z z 








O 














C 


Ol 




_J 


< 




Z 






2 










C 


j UJ Ul 


4 




U3 
















*> 


Ul 


03 03 




X 


or 


£ 






£ 












4 < 


5 


a, 


UJ 


E 






or 








C 




Ul Ul 


Ul £ £ Z 


<€ 




o 


2 




D 








o 


« 


j 03 03 © 


03 3 3 4 






z 


O 




Z 








© 


*> 




< t- t- 


D 




00 






63 






1 




* 


la a 5 


UJ < < £ 




u. 


< 






< 






i- 


m 






03 > Z 3 


U, 






< 










D 




> 


£ £ 


— < -» z 


o 


u. 


>- 


=3 




> 






£L 


• 


• 


Ul UJ Q 


Q cj or or 




o 


or 






or 




03 


TO 


O 


*- 




x < Ul 


03 




o 




< 


o 








C 


JD 


03 03 Q 


03 UJ CJ t= 


UJ 


o 


¥- 


z 


UJ 






0) 


_J 




•O 


!>> *- 


0) 




z 


< 


UJ 


z 




or 


> 




Ol 


4 


03 03 < 


UJ 03 03. 


— J 




or 


> 


a 


or 


o 


1- 


£ 


« 




£ 


NDDif 


< 


a 




or 


o 




e 


x a. 




a 


< 


a. a. 3 


K »- l- 


£ 


ss 


0. 


Ul 


X 


a. 




© o 


O 




a. 


03 03 U 


LUUUD 


O 




03 


a. 


i- 


03 


or 


D £ 


z 




X 


ui ui x 


*N QJ QJ M 


z 


_) 


Ul 


> 


K 


Ul 


h- 


O UJ 


m 


« 

a. 


CJ 


jor or or 


k 0. o. tr 


< 


u 


c 


X 


O 


or 


0) 


O X 


< 


-*« 
u 












o 




m 


0- 








C 


• 


I CD O OD 


■o to co n 




in 


o 


o 


o 


o 




CM P3 


* 






j 0- 0- » 


n «j- «»• <i 






o 


o 


o 


<3 


o 


•0 O 


o 




o 




n m m m> 


in 


CD 


CD 


CD 


CD 


CD 


CD 


CD CD 


CD 


0. 


cj 


J id in rx 


r». n 




|x 


fx 


fx 


fx 


rx 


IX 


rx rx 


fx 

















2 






O 03 


UJ UJ o 


CD O 


z 




1 




u 




3£ 




3 


Q 


a 


Ul O 


03 03 Ul 


OHIO 


Ul z z 




3 




UJ 




o 


m 




UJ 


Ly 


03 _J 


O O 03 


-1 03 Ul Z 


0, Ul Ul 




=J 


m 


z 


Ul 


UJ 




t= 


03 


03 


O O 


_) _l O 


(J O 03 Z Z Ul 


one 




•x. 


Q 




1=3 


2 




o 


O 


D 


-1 1 


U U _l 


i j o lu iy u. 


1 o c 


2 


03 


2 


0. 


It. 




ffl 


« 


-1 


-1 


U 03 


1 1 o 


CO U J 0. L o 


CD 1 1 


O 


03 


3 


£ 




■S 






u 


w 


1 03 


03 03 1 


00 1 O O CD 1 


03 03 03 




-a 


3 


> 


© 




2 


or 


1 


1 


03 — 


03 03 03 


— 00 1 1 1 03 


m 00 00 




2 


05 


03 


2 


o 


1- 




0) 


OB 


oo or 


M M 00 


or «* 03 03 SO 03 


OC M M 


< 


>. 






3 


< 


O 






M 




ec or *- 


c o o — — 


or or 




ts 


1- 


1- 


=) 




1 


63 


i 


or 


or ui 


or 


Z z Z or or 


Ul 




z 


03 


co 


1 


2 


or 


Ui 






UJ 


or ui 


Ul Ul 


uj or ui 


iSL 




Ul 


UJ 


03 




< 


K 


ffi 


Ul 


o or 


3 > x 


> or 03 oo uj O 


or 3 > 


03 




X 


X 


© 


2 


Ul 






2 


3 X 


O — — 


ui o oo «- z 5 


IO- 


UJ 


=j 


u 


w> 


Z 




£ 


2 


or 


P 


1- 1- 


U. U. 03 


co £ — or o t- 


K U, U. 


or 






x. 


















"x or 






3 


-I 


X 0) 


e 


© 




=J 


< UJ 


UJ 


U) Ul 


Ul Ul Ul 


Ul 1- Ul Ul Ul 


Ul Ul UJ 


-l 


03 


< 


© > 


z 


2 


0. 


3 


» rx 


or 


or or 


c or or 


or x i- or or or 


or or or 




£ 


3 03 






< 


u 


x 3 


3 


3 3 


3 3 3 


3 © _l 3 3 3 


3 3 3 


U, 


1- 


or 


O 


u. 


_J 


0. 


or 


> 1- 


l- 


K 1- 




h « D h 1- h 


H 1- K 




03 


o 


(J 0. 




=J 




UJ 


X (J 


O 


u u 


o o w 


U Ul £ U U U 


l_J <_> u 




UJ 


z 


CJ 03 


z 


UJ 


z 


03 


a. < 


< 


< < 


< 4 4 


4 4 4 4 


4 4 4 


< 


2 


IB 


— Ul 


ffl 


3 


m 


3 


03 or 


or 


or or 


or or or 


or x x or or or 


or or or 




o 


< 


X or 


< 


03 


< 


1- 


< u. 


u. 


u. u. 


u, u. u. 


u. u. u. u. u. u. 


u. u. u. 



CM 


















© 




r« n 


* tt <0 


fx CO O O — CM 


n <» « 


r> 




IX 


00 0> 








n 


o 


© 


© 


o o 


o o o 


o o o 


V4 V4 


>o 


-0 


-0 


•o o 


n 




m 


m 


» 


Fx 


fx 


rx rx 


rx rx rx 


rx fx rx rx rx rx 


rx fx fx 


CD 


CD 


CD 


CD CD 




CD 


0- 


0- 


Ch 


O 


© 


o © 


o o o 


© o o o o o 


o o o 


IX 


N 


|x 


rx rx 


rx 


fx 


IX 


rx 


IX 


© 


CD 


CD CD 


OD CD OD 


OD OD CD OD OD OD 


CD CD CD 



320 












NO 




o 




□ " U) Z E 


s 

0) 


(J >• 0) 


< 










Ui XT < 


—J 


U. 






z 




O Z O O M 


to 


Z O Z 


0. 




to 


> 






z a z « < 

Ul KL' 


| 




Ui 


K 






0} 




y y \ 




^_ 


u 




Ui 




u T 2 <r lij 

' ^ -fc- ^fc Hi 




Z 111 t- 




CD 






> 




a true 




«KU 


3 


1 


Ui 


< 








< 


Ul Ui 




O 




Z 




M 






Jt-0) 


t- 


M 


-J 


Ul 






« a. a. +* 


s§ 


Ui K Ul 
US < K 


u 




» 


> 




< 


ae < z z 


Ui 








< 


K 


U~Q.UK 


t- < 


o o 


oo 


> 


to 


u. 




Ui 


o. a < « uj 
I X 


o u 


Ui Z J 


Ui 




Ui 


o 




a. 


Ul 


> Ul Ui 


K 




> 






o 


uco< 


l-t t- 


09 




< 










Ui » 1 £Z 

co < a. 5 k 


Q 09 


O O 03 


CO 


> 


V 


§ 




> 


0^ 


M M ||| 


Ul 




M 




Ui 


a: 


CD IL Ui < Ul 


w o > 


> 




(J 




Q 




oe Z co 


u u 


< < 




< 


< 


< 




Z 




CKK 








u 


-1 


Ui 


« a. < 


K Z 


858 


8 


s 


s 




o 


i 


a o o < <r 
< a z « < 












_l 




Ui 


1- 1- H- 








0. 


8 


a: 


k < »- Q a. 




O ** Vt «* 01 O * 9- 9- ~ 0- ■** Oi ~ O- 0" n 9- 9- c* 

oooooooonnnnnnnnnnnnnnnnnnnr'jno 



321 



O E O O 03 





i<® 


© 


2 


© 


© 


95 


<€ 


2 






2 


3 


© 


m 


O 


in z 




2 






1 


u 


03 






□ 




3 


S 


3 


2 


us 


S 


m 


m 




2 




2 


2 


= 


UJ 


□ 5 


i 


2 


o 




D 


UJ 


2 






U Z 




2 


3 


_l 


3 


z 


2 


3 


3 


© 


O 


2 


i=i 


2 


2 


2 


Z -1 


2 


= 


UJ 




-J 


2 


2 






UJ 




U 


J 










yj 


UJ 


2 


2 


t=i 


K 












yj 


2 












< 


Z E 




s 




UJ 




© 


© 


3 


J 


2 




t- 


CS 


2 


2 


2 


E X O 




2 






2 


03 


03 




tr 


03 


t 


o 


ty 


ffl 


UJ 


2 


2 


6, 


as, 




<< 


ffl 


2 






6a 


UJ < UJ 


03 


a. 


£L 


< 


2 


> 


> 


© 


D 


a. < 


i 


(2 


a 


o 


a 


D 


3 






<€ 


K 


2 




S 


2 


UJ 


i- a: 2 


€ 




03 


UJ 


X 


03 


03 


2 


UJ 


03 -I 


K 


J3 


o 


_t 


P 


2 


2 




.J 


K 


3 


t-« 


2 


[=: 


(=3 


E 


05 o 




o 


UJ 


I 


© 






3 




uj a. 


t= 




J 




=J 


"s. 


V 


2 




3 


UJ 


Q 


UJ 




H 


S. 


>• 1 o 




UJ 


DC 


© 


2 


0. 


a. 


_J 




c o 




s 




yj 




2 


X 




2 


ty 


-J 




2 


tn 


cn 


X 




UJ 


2 




< 


O 


03 


03 






UJ 


e 


[=1 


e2 


j 


E2 


© 


© 


UJ 


yj 


J 


£L 






2 


2 


< 


-J 


E 




O 




61 


UJ 


UJ 


O 


o 


□ Z 


: 


•s 


2 


G 


UJ 


2 


2 




u 


a. 






t- 


«=« 






0. _l < 




© 


UJ 


!- 


m 


BE 


fS 


UJ 


UJ 


2> 




E 


B. 


a 


I 


C 


O 


2 


m 




_J 


H 


03 


Q 


o 


Q 


03 0. E 


Q 




2 










2 


2 






B. 




o 


5S 


<r 


2 






2 


2 


o 


UJ 


UJ 


2 


UJ o 


UJ 


-1 




D 


D 


O 








E 


|_ 


o 


3 


E 


=J 


Si 


s 


a, 


2 


EL 


O 


2 


2 


E 


2 




It UJ > 


2 


€ 


© 


1- 


!~ 


i- 


t— 


2 


> 


> o 


2 


w 
















o 


ty 












2 cr 




2 








•-< 




S 


< 


< H 




2 


O 


O 


o 


o 


o 


e 


O 


2 


2 


□ 


D 


O 


O 


O 


a < 


_l 




_l 


03 


to 


03 


03 


2 


X 


X < 






w 


UJ 


UJ 


UJ 


UJ 


UJ 


2 






yj 


UJ 


UJ 


UJ 


UJ 


UJ 2 o 


€ 


Q 












UJ 


UJ 


UJ rx 


2 


© 


2 


2 


2 


2 


2 


2 


2 


© 


© 


2 


2 


2 


2 


2 


2 © 2 


E 




E 


2 


2 


2 


2 


a 


03 


a >-i 


































« O 




O 


















_J 


-1 






_l 


_J 


_J 


-1 


_J 


_J 


_i 


J 




-J 


J 


-1 


J JU 


U 


© 


O 










o 


o 


© 03 


€ 


S 




< 






< 


S 


C 


2 


2 


€ 


< 


€ 




=2 


2 2 UJ 


UJ 


UJ 


UJ 


< 


2 


< 




2 


2 


2 UJ 


E 


£ 


E 


E 


E 


E 


E 


E 


E 


E 


2 


2 


E 


E 


2 


2 


E E 03 


03 


03 


03 


u 


O 


© 


o 


D 




D tx 



nnimfiiNNt\innnnt«»«'iBininNNNN----ini()inj> 
4<io-0'0<<i<HKm<n<nioiMHMM)'( i )nnni , )nnn 




fr- 3 

CO 

< fr- 

— CO 

Q Id 

" ' I 
u 




CO (0 
UJ UJ 
Q O 



< 

KCK 

ui **> m 
o < < 

< a. o. 

J UJ UJ 

c cc 
§xx 

IKK 

a 1 1 

< 0- 0. 

M < < 
O M ~> 

a a 

UI 

CUE 
D CO UJ 
HOI 

3 -J £ 
co o o 



UJ 

* u 

< ui o 
r z uj 
uj z 

Z _ 

< o z 
a. m o 

i- 

< < fr- 

k or < 

1 111 c 
0. CL Ui 

o z 

O O 
fr- < 
ZKU 

< X < 
J 01 c 

a. < o 
r - 1 

>- Q t- 



> 

to 
a. 
O 

> 

r cd 
o 

fr- _J 
O < 
*•* *— 

a a 
ce ce 
< < 

CC cc 
UJ UI 

a. o. 









^_ 


f i 












UJ 




to 






< 


u 


> 


CO 


< 




5 








a 




z 


S£ 


to 




x 


< 








< 


S 




o 


z 


o 


o 




to 


z 


o 


z 


a. 


M 


63 


> 






z 


CC 


z 




< 


< 




fr- 


< 


UJ 


ce 


M 


< 


CO 












2. 


r 


u 


u 




ce 


fr- 


u 




Ui 




fr- 




z 


< 


UJ 




z 


UJ 


fr- 




to 


X 




> 


1 


ee 




ce 


u 


s 


u 




CC 


u 


3 


i 


Ui 


< 






o 




Ui 


M 




< 




Ui 


Ui 




© 




z 


o 




< 




X 




<2 




-1 


fr- 


to 


►- 




—I 


UJ 




fr= 




a. 




a, 




£ O 


UJ 


CC 


UJ 


u 




Ui 




u 


< 


CC 




s 




Z 


o CC 


to 


< 


ce 


UJ 




to 






CC 


UJ 






u 


s 


fr- < 


CO 


Q 




to 


> 


to 






Ui 


CL 


e 


< 




a 


(J u 


UJ 


Z 


-l 


UJ 




UJ 




s 






! 




fr» 




UJ 


> 


UJ 


UJ 


ce 


ce 


> 




X 


o 


u 


CC 


&} 


< 




»-> fr- 






to 




< 






t= 




Ui 


+>* 


1 


X 


z 


Q 0) 


o 


o 


to 


to 


> 


o 


§ 




> 


to 


< 


0. 




ec 


CC UJ 


1-4 




UJ 


Ui 






i— * 


Ui 


ce 


to 




UJ 


< 


UJ 


< I 


o 




> 


> 




u 


fr- 


e> 


\- 


I— S 


UJ 


ec 






o u 


< 


< 






< 


< 


■€ 




s 


Q 


ce 






to 




CC 


ce 


ce 


CC 


ec 


CC 


u 


J 


UJ 






CC 


a. 


< 


CC z 


o 


o 






o 






U 


1 


Q 




o 


< 


ec 


ui a. 


I 


I 


s 


s 


X 


s 


_J 


u 


UI 


< 


ca 


X 




■=3 


a. a 




fr- 


fr- 


fr- 


fr- 


fr- 


0l 


o 


ce 


CC 


<€ 






a. 



^frn~«n*«£t>oi;r 

fn*«lONtDtDC0tDC0t5CJ^»W 

Innnoonnoonooor) 





in 


0) 


m 


ID 


r> 


r> 




r> 




8 




o 


« 


w 


n t> 


o 


^< 


n 




r» 


«o 




CD 








to 


CD 


CD 




to 


CD 


CO 


CD 


CD 


CD 


CD 


CO 


o- 


o 


n 


n 


n 


n 


n o 


o 


n 


n 


n 


n 


n 


n 


n 




«r 


r> 


n 


r> 









to 














> 


CC 




z 


u 


z 






fr- 


u 




















to 


r> 


s 






> 






X 


> UJ 


> 


o 


UJ 


o 






o 


UI 


UJ 








> 


UI 


X 






o 


r 




z 










o 


X <J 


X 




z 


M 




> 




o z 


cc 








X 


I— 








X 


> 




o 




§ 


> 




fr- 


o < 


o 






fr- 




X 


CC 


Z 










o 


t— * 


z 






> 


X 


< 




u 


fr- 


X 


>- 


to 


fr- _i 


fr- 


< 


CO 


(J 




o 


fr- 


3 O 


to 








fr- 


to 








I 


t- 


CC 




Ui 


u 


o 


X 


o 


to 


CD 


(J 


Ui 


UI 




fr- 


CO 


-1 z 


o 








o 




1- 


X 




fr- 




o to 


< 


z 


Ui 


fr- 


o 


UJ 


O — 1 


o 




_l 


to 




u 






-J 






u 


(J 


> 


to 


o 






u. 


_l z> 






o 




fr- 


X 


Ui < 


Ui 


-I 




UJ 


o 


UJ 


u 


U. _l 


u 






UJ 


< 




< 


< 




it. 


o 


a. x 


CO z 


z 


> z 


UJ 


u 


u 


X UI 


X 


Cv 


o 


CC 


z 


z 


< 


o o 








z 


or 


o 


»— « 


cc 




o 




X > 


D < 


o 




o 


Ui 


< 


U X 


u 








r> 


o 


or 


z u 


z 


u 


fr- 




o 


fr- 


Q 


I 


to 




z 


UI X 


X -1 






z 


o 


CC 


< V 


< 


CO 




o 


_l 


X 


o 


zoo 


o 


UJ 


z 


z 


I 


o 


UI 


CL 


t o 


z 


o 


vV- 


> 0. 


fr- 


fr- < 


> 


z 


fr- 


CC < 


CC 


UJ 


-1 


z 




r> 


X 


O -1 




z 


< 


o 


fr- 


o 


r 


< 


i z 


o 




Q 


X to 




U -J 


CC 


> 




fr- ec 


fr- 


-J 






u 


UI 


fr- 




fr- 




_J 






<I 










to 


_J u. 


fr- z 


CC 


Ui 


< 


ce 




fr- 




o 


o 


-1 


o 


z 




to u a 


< 


or 


a. 


fr" 


> 


cc 


u 


Q 


! > 


to 


1— « 


Ui o 


< 


u 


O fr- 


_l 


< 


< 


X 


u 




o 






Cv 


o 


M O < 


cc 




to 


< 




o 


o 




1 X 




CJ 




u. ce 


OL 


Z CC 




-i 


z 




o 


< 


_l 


_J 


> 




UJ 


u _l 


UI 


< 


z 


cc 


o 


I 




u 


o 


o 


X 




o fr- 


o 


> < 


Ui 






ui c5 




X 




< 


X 


UI 


to 


x Z _) 


u 


a. 


< 


UI 


t- 


fr- 


z 


o 


1 »- 


X 


Ui 








CC 0. 


fr- 


— I 


fr- 


0. 


Ui 


Ui 


> 


fr- 


o 


fr- 


to 


UI o o 


< 


UJ 


cc 


a. 


< 




o 




1 u 


Ui 




CO 


ee to 


to 


< 


Ui 


< 


to 


Ui 


CC 


CO 


o 


z 


fr- 


UJ 


t— 4 




-J 


cc 


fr- 


o 


ce 


z 




> 


1 Ui 




_l 


5 to 






-I or 


_J 


(J 


< 


CC CC 


z> 


> 


CC 


UI 


u 


_l 


a 


cc to 










o 


UJ 


to 


to 


1 X 


fr- 


< 


X *-> 


< X 




M Ui 








Ui 3 


to 


X 


fr- 




UI 


CL 




UImO 


o 


cs 


o 


C5 


J 


Ql 




CL 


1 > 


ee 


fr- 




0. > 


> 


X X 


X 


Q 


Q 


X fr- 


o 


CL 


CO 


G> 


00 


r 


a 


X u cc 


z 


z 


z 




a. 


o 




o 


X 


< 


o 




Ui X 


X 


Ui fr- 


o 


< 


UJ 


fr- D 


-I 


X 


UJ 


UI 


o 


o 


< 


fr- Z D 










X 


UI 


z 




1 »- 


Q. 


fr- 




CC fr- 


fr- 


X o 


<J 


CC 


X 


o to 


o 


UJ 


a 


to 


_l 


u 


or 


o «-> to 




_J 


_l 


J 


LU 


cc 




m 



o — w •* w n <* c o» t> - c* — O' c n a- o- cm n 

O0303t^t>'0 k >>-N( , )*riiwsNNNn*in > 00'^n't*«0'OO-rii 

oooooooonnonnonnnnnnnnnoonnnnnnnn 



x xi- r 


z 


X 


X X 






z 












z 


z 




X 




O 




























O X Q to u < 




a 


Q Q 


(D 






X 




X 




a 


< 




X 





X K 


Ul 




z 
























ft hi l|j w 
U IU IN ^ 








UJ 




s 








m 

UJ 






i 


ft 




ft fft 


rt 
U. 




s 














z 








u 


O nun til 

U U ~ Up UJ 




Q 


H O 


H O 








Q. 




UJ 


o_ 










III 

IM 




<— 










UJ 








X 




X 


K Ul 






e 


J (- 


UJ 


X 









O 




CD 









-1 


O K 


z 


< 






Q 




Ul 




z 


i 


Q 


X 


O 


CO 0. 


UJOXZO 


r 


u 


5 CD 


Z 0. 


ut 


E 


oc 


1- 


K 




Z 





z 


oc 


5 


t- 


3 


X 




□ 




□ 


t- 





< 






a 




Ul CO 
K Z 






M 


<J i-i 


1- 05 




<£ 


u 




m 


I 


3 


z 


< 


u 





10 z 


1 


UJ 


Z 


or 




1- 




Ul 


X 




O 




□ 




X 


C 


1 z 


?5 





X 


M 


3 




1= 


1 


1 

CD 


X 


»— « 


1 


« t- 


05 




< 





-1 


co 


Z 


0. 


Ul 


Z 


or 


t- 




5 




UJ 




>• 1 




z 


UJ 


z 





Z 


O 


CD 


UJ 


z 


CO 


z 


*— « 


O 


X 




D 






05 


< 


u 


_i 


05 


z 1 




1 




H >- 


H 1 


1 


1 


1 


1 


1 


1 




« 


1 


1 




1 1 


CO 


z 


Ul 


z 


(J 


z 


O 


□ 


X 




D 




K X 




> 






M 0) 


CD 


0) 


01 


to 


CD 


CD 


CO 


CD 


CD 


CD 


CD 


05 CD 


< 


1 


1 


1 


1 


1 


1 




z 


Ul 

1 


Z 


O 


z 


O < 






> 


> > 


> 5 


i 




? 


i 


2 


i 


O 


O 


O 


O 


O 


O O 


(- 


1- 


»- 




t- 


1- 


1- 


1 


1 


1 


1 


1 






< 


< < 


4 Z 




Z 






z 




or 


OC 


OC 


or 


or 


or or 


u 


<J 


u 


O 


U 


u 


O 


< 


< 


< 


< 


< 


< 


< O 


fiQQQUU 


> 


u 


u o 


o a 




(J 







£ 


M 


a 


a 


a 


a 


a 


a a 


UJ 


Ul 


Ul 


Ul 


Ul 


Ul 


Ul 








M 






M Z 




< 










Z 










*— 1 






i—t 




1-1 « 


M 




M 


M 








z 


z 


Z 


z 


Z 


z 


Z H 

a 


iiiiza 


o 


3 


3 3 


3 O 


□ 


□ 


s 


§ 








u. 


u 


u. 


u. 


u. 


u. u. 


z 


z 


z 


z 


I 


z 


z 








□ 


















a 


a 


OC 


K 


K 


oc 


oc 


























u 


u 


z 




z 




1 




i§ 


o o o o 3 o 


o 


O 


O 9 


O 09 


a 


a 


a 


Q 


a 


a 























z 




z 


z 


z 


3 






§ 








Z Z Z Z Z 2 


z 


z 


z z 


z 














§ 


1 


z 


z 


z 


11 


□ 


□ 


a 


□ 


□ 


□ 


□ 


Ul 


u 


Ul 


Ul 


Ul 


Ul 






3 


3 








h 


u. 


u 


h 


u. 






3 


3 






or 


or 


or 


or 


or 


or 


or 


z 


z 


z 


z 


Z 


z 




_J _1 _l _l _l -J 


_J 


-1 


J -1 




O 




□ 


□ 











-J 


_l 


-J 


-i -j 


a 


a 


a 


a 


a 


a 


a 


0. 


0. 


0. 


0. 


a. 


0. 


0. a. 


CD BO 09 CD CD CO 


CD 


63 


a a 


so a 


a 




a 


a 


a 


a 


a 


a 


a 


a 


a 


a a 


a 


a 


a 


a 


a 


a 


a 


a 


a 


a 


a 


a 


a 


a a 


H K t- »- »- H- 


t- 


(- 




»- H 


H 




l" 




t- 


t- 


t- 




t- 


t- 




»- »- 




K 


i- 


1- 


i- 








»- 


1- 


K 






*- H 


n * ft -o o — 


N 


n 


* ft 


«o o 


«-* 




n 




ft 


«0 







CM 


n 




ft <o 


O 


«4 


fd 


C5 




ft 


<o 


O 




(M 


n 




ft 


«0 O 






ro 


N W 




n 


n 


n 


n 


n 


n 














ft 


ft 


ft 


ft 


in 


ft 


in 






<i 




-0 






«4 «4 «4 H H 












































«-« 


















o o o o o o 


O 


o 


o o 


o o 
















O 


O 


O O 





O O 


O 


O O 


O 





OOO 


O 


O 











O O 



z 

u < 
UJ x 
< 0. Ul 
n 0) CO 
Z (0 z o 
O Ul 3 Z 
Z U I I 
3 (0 x x 

uj a uj ui 

Z < _l -I 
0. 0. 0. 

o z z 

~ o 
u 



V Mm 

< z o 

JO (J 

1^1 



Ul 



a a 



Z OV H 

o « . 

z a E z 

_j Ul 1-1 1-1 

< z oc or 

CO < OL OL 



Z x x 

X £3 X O 
Z Q 
3 O 

or »- »- 

EU JO 

X M 3 M 

IHEUI 
I I I I 

X X X X 

Ul Ul Ul Ul 
J J J J 
0, 0. 0. 0. 

§000 
u u u u 

a a a a 

»— •— 1 — 1 — 



C30 O 
Ul Ul 
H 0. 

zi 

•— 3 

I 

1 > 
x CO 

-I OC 

a. 3 

S3 

o a. 
a a 



E 

< Z 

x * 

Ul Z 
3 

O 

Z Z 

I < 

> x 

CO UJ 

« I 

or or 

3 3 

a a 
0. 0. 

a a 

»- H 



x x 

q a 

a t- 

1-1 O 

z 1 

1 > 

CO 05 

or or 

3 3 

Uj-Uj 

a. a. 



X K 
O CD 
UJ 
O H 

00 Z 

Z O 

I I 
CO CO 

oc or 

3 3 

a a 

0. 0. 



E 

o < 
Ul x 
Ul 



05 



EEEEEEEE 



a a a a 

»-»-»-»- 

E E 



Z O 
3 Z 

I I 
U (J 
UJ Ul 

z z 
a a 



o o 

o o 

or a 

0. a. 



Z x 

i° 

3 o 
a 

E U 

< 1- 

x E 

Ul I 

I u 

(J Ul 

ui z 
z 

a 
a h 

O 

a a 
0. 0. 



Z Z Z Z Z Z E 



X H 
Q CO 
Ul 

OHO 
K Ul 
(0X0. 
« H CO 
X □ Z 
I I 3 
O (J I 
gujg 

Z 

a a 

k t- a 
t- 

o o 

a a > 
a a. a 
< 

ZEE 



x 

UJ E 
< 

x 
Z UJ 

1 I 
CD 05 
O □ 

z z 

a a 



x 

Q x 
Q 

O 

a t- 

-J 

« 3 

Z u 

1 I 
05 05 
O □ 

z z 

a a 



x t- 

Q 05 
Ul 

O I- 
»- 

a z 

►1 H 

z o 

I I 

05 0) 

□ a 

z z 

a a 



z 
z * 

U < Z 

Ul x 3 

0. UJ 
05 E 

Z O x 

3 Z Ul 

I I I 

a a a 

1 — 1 — • — 
1 _i t 

M M H 

u u. u. 

z z z 



X X 
Q x Q 
D 

O 
thh 

O _l 05 

M 3 M 

Z O z 

1 I I 
a a a 
h h t- 
J J J 

M W « 

ILILL 

zzz 



05 Z Z 
\tliJ < X 
hUXZ 

a uj 3 

Z 05 

I- z o z 

□ 3 Z < 

I I I X 

a a a ui 
k < < 1 
j J j j 

-> 3 3 3 
LDQQ 

z o o o 
-zzz 



>>>>>>ooo 
aaaaaazzz 

<<<<<<333 
EEEZEE-I-J-I 



aaaaaaaaaaaaaaaaeaaaaaaaaeaae 
aaaaaaaaaaaaaaaaaaaaaaaaaat-t-t- 



0000000 
z z z z z z z 

3 3 3 3 3 3 3 
J J J J J J J 

C3 09 GO 03 OB OQ GQ 
K »- H »- H K »- 



(UtOOOOOQOxwMriMftMOIDOIIIOOOIMMMMMI'O'OOOOOOOxHx 

nooooooooooooooooooooooooooooo^ — — - 



0000000000000000000000000000000000000000 



_ z 
u o 



ZQKQO 
3 O UJ 

O OKX 
tKI-l" < 
< U J 01 I K 
X "-• 5 « K I 
UICUZOK 
I I I I I z 
o o o u o < 

III UJ UJ UJ Ui 
Z Z Z Z Z > 

or 

B P9 B B B < 



0. 0. 0. 0. 0. C 

01 01 0) (D tO —I 

ui uj ui uj u 5 

KKCIKKL 



OC 

»- z 

CJ 3 
< J 

pa 

o u. 
u o 
> 

z n 



> to 
oc < 
< •-• 

Z Q 

is 

0. o 



s 

(J _ 

^§ 

□ UI 
Q Z 

m a. 
o 

-> to 

a a. 

•M < 

a u 

_ r 

(J 01 

< 

> _i 
oc a. 
< o 

£ H 
m CD 

oc -> 
a. z 



< < 



28 



o o 
z r 

3 3 
UI UI 

z z 
a. a. 

a oi 

3 « 

q to 

ci 

(0 CD 
< < 
-I -I 

a. a. 
o □ 

K K 

CD 03 

X X 



O 01 

z « 

_l « 

z 

Z 3 

CD < HI CD 

to O 0. 01 

< o 

h U 4 H 

Z O Z 01 

•-• O 01 > 

z o < u 

O O _l o 

o z a. z 

< •-■ O 3 

eixu 

< O o z 
a. uj k a. 



01 

s 



(J 

(D U. 
UJ Z 
(T <~ 

. £ 
m ai 



(j Q3 

UJ £ 
U. UI 
U. 

UJ Z 
□ 
UJ z 
I- _J 

< 3 

_j a. 



U 0) 

ui g 
z z 

< < 

z z 
o o 

§§ 

UJ UI 

z z 
a. a. 

-i _j 

< < 
a: oc 



< 

•-■ Z < w 

§iz§ 

£ 3 O £ 
3 UI £ 3 
UJ Z 3 UI 
ZLUJZ 

a. z a. 
u o. 



< •-• j 
u z < 



o o 

□ Z O UJ 

<J 3 E 3 
OHIO J 

z z a u. 

3 a. 3 z 

UJ UI M 

Z . 01 . 

a. * a. x 



< 

< ►* 

•H Z 

z o 

2§ 

3 UJ 
UI Z 

z a. 
a. 

-i 

-j < 

< a 

o u 

u o 

O O 

u o 

-I 
K > 

a. x 
ui a. 
a < 
t- »- 

01 CD 



U 0) 

ui o 
z z 

< < 

id 
§§ 

UI UI 

z z 
a. a. 

-j -J 

< < 

a: oc 
ui ui 

»- H 

<J CJ 

< < 
as a 



CO X 
O « Ci 

S! 3 

-I o 
£ u 
03 Z a. 

M M O 

z □ 

< O X 
O 111 3 

a: £ 
o □ z 

> 

< u < 

Z 3 Z 

o o 



3§§ 
UI UI UI 

z z z 
a. a. a. 







CO 






01 












Ui 


<j 


CD 


m CD 










CD 


CD 


UJ 


O 


t- « 


<J 


01 








O 


z 


z 




UJ 


□ 




X 


CD 


a 






X ~> 


z 


z 




< 


a 


> 


CD 


o 


u x 










-i 


£ 


►— 


cr 


Z CJ 


cn 


01 03 




s 


-i 




a 


o 


o z 




M U 




»- 




CD 






oc o 




h- _l 




Z 


o 


> 


i- 


< 


n oc 




m m 




< 


oc 


CD 


o 




aa 


i 


X 






UJ 




UJ 


z 


oc 


o 


U CD 


u 


Z 


a. 


X 


u. 


o 


1 £ 


z 


Z 3 


UJ 




CD 




z 


£ 


(J X 


o 


o o 


z 




< 


o 




3 


o 


cr 


cr t- 




< 








UI 


-1 


03 


03 < 


< 




Z 


z 


Z 


z 


3 »- 




£ 


r 


Z 








a. 


OC o 


o 


U UJ 


Ui 


O 








o 


3 3 




i-i to 


CO 


£ 


£ 


£ 


£ 


u 


o. cr 


z 


z > 


> 


3 


3 


3 


3 


z 


O K 


o 


O X 


X 


UJ 


UJ 


UJ 


UI 


o 


O CD 


cr 


OC 0. 


0. 


z 


z 


z 


z 


cr 


3 03 


X 


X £ 


£ 


a. 


0. 


0. 


£L 


cq 


£ □ 


o 


(j uj 


LU 











r> 




fi 












CD CD CD CD CD 


o 


♦ 


o 


o 




0* 


CM 


«i 




n 


o 


CM CM CM CM CM CM 


v4 


CM 


* 


m 




IO 




CM 


O 


-0 




•4 H H H •< (t| 


n 


«4 






— * 


«4 


CM 


CM 


n 


n 


n 



o o o o o o o 



CD 


(h 


n 




n 


in 


«0 




CD 




— m 


CD 


o O 


CD 


(M 


ni 










t 




m 






- CM 


CM 


CD 


CD 


CD 


CO 


CD 


CD 


CD 


CD 


CD 


CD 


Ch 0" 


Ch 


Ch 0> 


0- 


«r 
















t 


«*■ 


«• * 




«■ * 







1 Z x 


x CD £ 














£ 








m 


l£ X Q x 

i< z a 


Q UJ O < 


z 










u 


< 


z 






— 


h 111 X 


* 


X 




X 




Ui 


X 


aC 


X X 


t- 


mm 


IX 3 o 


O 0. UJ 




Q 


X 


o 


CD 


0. 


UJ 


Z 


a x a 


03 


o> 


lUi 0C K 


H X 01 






Q 




Ui 


CO 




3 


Q 


UI 


c 


E O _l 


(OHZO 




O 




o 


H 




o 




o o 


H 


Ui 


IO < - 3 


O 3 Z 


£ 


cr 


1- 


»- 




f 


z 


£ 


tt h h 




IZ X £ (J 


XIII 


< 


<j 




03 


I 




1 

CO 


< 


O _l CD 


I 




1 1 UJ 1 1 


I x o u 


X 


M 






1- 


CD 


X 


M 3 1-1 


t- 


• 


IX 1 X X 


x < UI UJ 


UI 


£ 


o 


X 


O 


i 


o 


UI 


E U X 


O 


4* 


l< X < < 


< cr Z Z 


1 


1 






1 




z 


1 

CO 


1 1 1 

to to to 


1 

CO 




ioc cr cr k 


or cr 


(J 


u 


(J 


u 


u 








IO o o o 


O O 03 03 


UJ 


UJ 


UI 


LU 




03 


03 


o 


o o o 


o 


> 


IX X X X 


IIHK 


z 


Z 


z 


z 


% 






z 


z z z 


z 


• 


!#—•—•—»— 


H 1- 
























IOOOO 


O O > > 


oa 


00 


03 


03 


03 


> 


> 


03 


03 03 03 


03 






£ £ cr OC 
3 3 < < 


l- 


h- 


t- 


H 


1- 


OC 
< 


AR 


K 


h- H 


K 


< 


1 Ui UJ UJ UJ 


UI UI Z Z 


z 


Z 


z 


Z 


z 


z 


z 


Z 


z z z 


Z 




IZ z z z 


z z g o 




O 


o 


o 


o 


o 


o 


O 


o o o 


O 


< 


10. 0. 0. 0. 


0. 0. £ £ 


? 


£ 


r 


£ 


r 


£ 


£ 


£ 


£ E E 


E 






03 03 5* 3 


-1 


-I 


_i 


_J 




-I 






_J _J — 1 
3 3 3 


_J 


X 


1 03 03 03 03 


3 


3 


3 


3 




3 






3 


o 


11-t-hH 


KhLO. 


0. 


0. 


0. 


0. 


0. 


0. 


a. 


0. 


a. a. a. 


a. 



z 

3C X 

£ z a x 
< 3 a 
x o 

Ui £ OC I- 
< CJ> _l 

x i-i 3 
Zulu 

1 I I I 
>>>> 

CO CO 03 CO 
>— I >— 1 »-• I— 1 

oc cr cr cr 

3 3 3 3 
UJ UJ UI UJ 

—I — * I I 

a. o. a. a. 



u 

X UI 

a a. 

01 

o k z 

o to 3 
-I ui I 

i- to 

K UI 
CD X O 
K O 

X o z 

1 I 

>><J 

01 01 « 

H H U 

0C DC < 

3 3 0C 

ui ui a 

J JZ 

a. a. k 



z 

at 

£ Z 

< 3 
X 

UI £ 
< 

x 
Z UI 

1 I 

UI UJ 
O Q 

o o 
z z 

X X 

< < 

oc tr 

O o 

X X 



X 

Q x 

o 

o 

cr »- 

_J 
- 3 
E U 

1 I 
UJ UJ 
O Q 
□ O 

z z 

x x 

< < 

cr cr 

o 

1 X 



x o 

l I 

UI UI 

Q Q 

□ O 

z z 

x x 

< < 

OC oc 

o o 

x x 



£ 

U < 

UJ x 

0. UJ 

in 

Z o 

3 Z 

I I 

m co 



< < 

LU UJ 

X I 

U (J 

< < 

oc or 



x 
Z Q 

z o 
3 or 
u 

E — 
< E 

x I 
UJ ca 
l t- 

03 

t— X 
u 
X < 
o or 

or 



x x 

q a 

►— o 

_i i- 

3 CD 

O « 

I X 

CO I 
03 
H 

-I 

< X 

UJ CJ 

X < 

o cr 

< H 

oc 



X 

I— o 

UJ 

1 a. 
m cn 
i- z 

3 

X I 

(J (J 

< LU LU 

or Z Z 



r 

< 

X 

LU 

o 
z 

I 

o 



ca m 



03 09 03 03 03 



m 


03 


03 


03 


CO 03 


m 


m 


i- 


K- 


1- 


H 


1- H 




»- 


•0 


O 


y> 




n * 


m 


•0 


o 


*— 






*— «-l 


<— 


*-* 


CM 


CM 


OI 


CM 


CM CM 


rw 





< < < 

_I_J_I_J_I_)_IQlD. 

ooooooocncn 
cotncncocnincoLuuj 
___ 1 ____oror 



OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO 



325 









(J 














o 




K 


















U ID 




z 




tn 






< 


u. 










UJ O 




5 




> 




r 


E 




i 






(D 


z z 




-j 




to 




UJ 




& 








M 














(0 




to 








0) 


> > 


UJ 


< 




tr 


1 ID 


> 


> 


z 








< 


_l _J 


EE 








i to 


X 


X 




o 








< < 


D 






a. 


1 0. 




a. 


u 




o 


03 


u u 


E E 


_J 






tn 


1 < 


£ 


e 


E UJ 




z 


i 


UJ UJ 


o o 




< 




UJ 


1 -J 


UJ 






tn 






z 


z z 


< 


K 




tr 


1 -1 


4 Z 


> 


-i 




X 


< < 


U, 


»- 




i 


I o 


-J 


> 


a. uj 


o 




> 


o > 






N> 


E 


E U 


1 (J 


€ 




e3 








li 


> > 


> 


t- X 


tn 


tn — 






S 




fe 


: 




tn a 


EE 


tn z 


M 


« _i 


1 > 






3 UJ 






E 


0C E 


o o 


□ 


UJ > 


-J 


_i a. 


i tr 


M 


< 


< to 


(- 


0) 




B O 






X EE 


a 


□ E 


i < 




cn 


0C 


**« 






z 


< < 


< 


O < 


SB 


03 O 


1 z 


to 


z 


»- Q 


z 


to 


< 


z < 


oc oc 


EE 


_l 


E 


E U 


1 o 


CC 


yj 




UJ 






UJ 






_l 


UJ 


UJ 


i r 


UJ 


a. 


1- O 


o 






o o 


a. a. 


Q. 


•-" z 




o 




h- 


£ 


tn z 


z 


UJ 


z 


z z 


tn tn 


to 


< EE 


EE 




14 


Z 


a 


□ 3 


o 




D 


O 3 


UJ UJ 


UJ 


-J D 




i a. 




o 


a. -J 


o 


< 




O -1 


OC OC 


EE 


U. OB 


< 


u. to 















o 


- O 












1 O 






r> co 


* 


rs 


o 


<0 -0 


OD t> 




* -« 


O 


— n 


1 © 


2 


00 


tD 03 




CD 


03 


at at 


CD CD 


» 


N N 


CD 


cd rv 


1 










t 








O 


O <r 


m 


m o 


IK) 


n 


n 








IS 


rs rv 




rv 


OD 0* 


o* 


a- th 



X 


X 


X 


s 




H 


;= 


t- 


(= 


2 


to 


w 


05 


CD 


S 


€ 


-s 


< 


4 


1= 










03 




Cfi 




en 


< 


< 


s 


< 










H 


5= 


03 


W 


< 


93 


« 


=' 












a 


tn 


□ 


03 


€ 


V 










3 


s 


3 


2 


CO 


<£ 




■Cf 


"€ 


o 


2 








■s. 


E 


S 


Z 


s 




H 


i= 




i— 




a 


LB 


00 


03 


C 


< 


€ 


< 


<€ 














X 


X 


S 


2 


CO 


UJ 


UJ 









< 

E 
X 
»- 

tn 
< 

tn 

D 00 

I- « 

< tn 
t- < 
tn k 

u 

3 UJ 
t-t 

< X 
E U 

X z 

K O 

tn cc 

< ts 



u 
a uj 

ui z u tn < 

Z III H H 

Z Z K Q 

H O i- < 
UU>ZE 
3 O X O 

S S ^» 3 5= 

K 3 < D v 

03 UJ 0. UJ Q 

azoz 

OLZLlL 
O M 

>t-ri-z 

3 2 UJ E E 

or o z o 
-■ a. > _i 

< O v 3 
CChQL 
OC O 03 O 
IZDOU 
UhQQ.4 



Q 

< < 

CC -I 

I- t— 

V 10 

Q <-. 
U. 

U. 

•» X 

Z t- 

< « 

E 3 

-J < 

3 E 

Q. UJ 

> 

oc a. 

X E 

U UJ 



t- Z 
< O »-i 
JZ K 

o tn. 
t- tn < 

« u. z a 
u. u. 5 uj 
uur 
□ «s 

meu.Il 

3 D O O 
UJ 

■* _l 03 03 

E QL U3 03 

UJ UJ UJ 

> »- o u 

0. O CD 03 
E < 03 00 
UJ 03 <£ < 



© 


94 


o 


«4 








o 


o 






> 


th o o ~ o 


o» — o — 


n 




n 


n 


n 


n*<n*MDcoo 


O P3 f*3 




t> 




£> 




(MMhOOOOO- 


H H P4 










■Cf 




in in n n 



m 

Q 



0- 



z < 

3 oe 
t- 

3 a. 
a. tn 
(0 ui 
oe 

-l 

< _i 

£ 3 

oc u, 
□ z 
z - 
m < 

< o. 



a. 
§ 

_j to 
^ a 

(0 z 

tn 3 
rS 

O H 
Z (0 
fi til 

-I X 
-I u 

ui 

3 -> 
(0 < 
£ 

U) O 
Ul Z 

z a 
u < 



ui —I 
Z Li 

0. u 
£ 

(0 z 

3 

z-8 

u z 
z to o 

C9 > Z 
S 10 UL 

u a. 
u to z 

m UJ CO 
X DC < 



> 
a 

to «- 
(0 

u 

Z X 

3 »- 
u. o 
i 

> oe 

DC < 

< UI 
Z £ 
g (0 

_i a. 

3 « 
0. 0. 

Z Z 

to a 

< < 



go 

M UJ 

»- to 
o o 
< -I 

UI U 
OC I 

to 

SI 

UI 

k a 
z oe 

M 

o 3 

CC I- 

Ul U 

CD < 

3 OC 

K U. 



Q 
O ui 
UI U) 

to O 

-I 
-I u 
U I 

1 to 
b m 



a 

ui 
to 
o 
-i 
u 
i 

£ 

cc oc z to 

OC CO 
Ul O UJ M 

z 3 k ae 
o t- to 

< 

u z 
o « 
_l < 

to OC 

« 0. 

a to 



ce 
< 

to _J _l 
O 3 < 
Z U z 

OC 

£ > UI 

5 < i- 

z _i to 

oc o o 

ui O oc 

K Z O 
to OC 



UI UI 

oc ce 

3 3 



UI O 
t- X 
0) CJ 



z z z 



< < 

OC OC 

u u 



< < < 

OC OC OC 

a. a. a 

to to to 



< 

UI 
O X 
UI U 

z < 

OC 

£ 

3 

Z Z 
OC « 
UI 

t~ > 
to a 
o 
u so 
o 

z 
z o 

< UI 
OC OC 
0. o 

to u 



u < 
UI to £ 
Z O UI 

to z to 

3 O > 
X Z UI X 
USUI 
Z _J OC £ 
O I- UI 
OC X 

on o > z 
Z ce < 
> O O H 

o ce i- 3 
a on < u 

CD V. OC 00 
X « 3 
ZULU) 

o < to 
m ce ui £ 
ui k ce 3 

OC < 
O CD CO OC 
IllLllI- 






u 












X 


X 


X 


X 






00 


00 


u 












3 














»- 


t— 


K 


£ 


1- 




M 




o 


o 


to 




(0 


OC 










u to 


to 


CO 


CO 


co 


X 


< 


< 


U CO 


z* 


UI £ 


UI 


o to 




M 


H 








CO 


UI o 


< 


< 


< 


< 




£ 


oc oe 


UI o 




z o 


z 


Z O 


Ul 


Q 


to 










z z 










to 


X 


Og 


z ce o 


CO 


< 




z 


z 




CO 




to 




»- 






to 




CO 


< 


K 


00 •-> 


i— t 


ui oe 


UJ 


UI 




oe 


o 








—t 


to to 


< 


3 


< 


3 




co 


to t- 


X »-i _J 


o 


to X 


to 


CO £ 


£ 


00 »-« 






1- 




X 


>— 1 •— 1 


1- 


I- 


1- 


»- 


CO 


< 


3 O 






< 0. 


< 


< oe 


CC 


»- a. 


o 


to 






o 


1- K 


co 


< 


CO 


< 


3 




U £ 




CO 


UI < 


w 


Ul UI £ £ O Z 


o 


to 


Z 


t— * 






z 


M >-« 










1- 




U 3 


O £ O 


3 


to « 


to 


CO CO 3 3 Z O 


z 


H UI 




K 




CD 


o 


X X 


o 


to 


o 


09 


< 




UI UI 


ZJu 


I 


<- Q 




•-" < I- f- CO *>* 


CD 


(J oc 


CO 


*— » 


i— < 


O 


oe 


o o 






s 






1- 


z 


»- 3 


u 


(0 Q 


a 


a ui < < < 


< 


UI 




I 


x 


Z 


m 


z z 


3 


3 


3 


3 


00 


< 


O 0. 


o a. > 


z 


U 




to > z < 




a to u 




O 


(J 






o o 












H 




£ £ 


o 


K £ O 


T. 


r m < m > _i 


> 


to >-> *-< 


»— « 


2 


z 


CO 


cc 


OC cc 


< 


< 


< 


< 


o 


03 


3 10 


3 £ O 


oe 


«-> 3 


UJ 


Ul Q U K CC ►> 


a: 


30)2 


UJ 


O 


o 


1-4 


X 


00 00 


£ 


£ 


£ 


1 






z 


Ul< 1- 


CD 


Z z to 


1- 


1- x<Oh< 


o 


to O UI 


X 


EC 


ce 


1- 


u 




X 


X 


X 




3 


3 


> UI 


Z _l to 




« i- oe 


10 


tOCOUIUHZUIt- 


i a o 


u 


09 


m 


« 




u o 


1- 


1- 




1- 






0) H 


0. U O 


< 


K UI 


> 


> * < UJ z < 


> « o 


< 






x 


UI 




co 


co 


CO 


CD 




< 




Z UI 


UI 


to to O 


to 


CDUJC0C0Ct>0.0C 


oe o x 


a: 


UI 


UI 


u 


_J 


z z 


< 


< 


< 


< 




r 


oe »- 


»- « I 


X 


< < oe 




m 3 3 ~ a. o 




ui u u 


i- 


1- 


i- 


z 


a. 


o o 










X 


X 


3 Z 


ZhU 




( •— i Q 


a. 


O. 1- 1- 1- Q. Ul I 


CL 


tO 0C > 




3 


3 


o 


r 


ce oc 




1- 


1- 


1- 


i- 


i- 


UI O 


o to < 


< 


Q Q 10 


to 


couioucoQ.»-eo 


03 < 0) 


u 


u 


u 


cc 




I I 


X 


X 


z 


Z 


CO 


CD 


-i a. 


a. o k 


ce 


UJ UI « 


UJ 


ui»uiuiui>ceui 


o to a. 


< 


< 


< 


CO 


to 


o u 


UJ 


UI 






< 


< 


Ol to 


to a. »- 


i- 


X X o 


cc 


trn-ao-criocc 



tn 



to 
> 





o 












o 




o 




o 






CM -> 




o 






o 


CD O- 


o 


o 






0^ 




o o 


m <o 






-0 


o 






n 


n 


n 


n 


n 






N O O 




>0 




o 




0- c> 




0- 






tt- 




»m it 


> ^ n 


««• 






f 






«1 










• 


r> m 



h rv o " (m o 
o«-rvn*tDO'OtDODOOOO'- | tMn 

IMMMMMMhD44'4'll'0'0<l<l'0 

mr»mmir)«inr^NNi^Nr^r^NrvN 



419-177 O - 



84 - 



- 22 



327 




en 
UJ 


LU 




z to 


z 


z 




_l 


f- 


o 


10 


Q 


Ul o 


Ul 


UJ 






to 


-J 


o 


Ul 


ZQ.J 


a. 


a. 




x 


Ul 


o 


<J 


to z 


Z III o u 


O 


o 


< 


o 


I 


1 


u 


O Ul 


Ul 0. 1 1 
0. O tD X 


i 


i 


Ul 


u 


o 


CD 


1 


-1 CL 


X 


x 


i 


I 




OS 


to 


«J O 


O 1 CO Z> 


D 






< 


tc 


M 


CD 


1 1 


1 10 n. z 


Z 


z 


< 




r> 


ce 


k— « 


to to 


eo co te te 


te 


te 


te 




-> 


UJ 


CC 


ii 


MM uj 


Ul 


Ul 






z 








t- 


i- 




< 


M 


Ul 


IK 




UJ to 


(0 


ta 


U. 


tc 




s 


D 


to m 


woo: 
Z 5 I Ul 






a 




K 




O 


m m 


u 


z 






Z 




w 


« te 


OhHO 


o 


o 


a 


Q 


M 


< Ul 




K 






M 


z 


Z 




tu 


Ul 


Ul Ul Ul Ul 


Ul 




r> 




u. 


m tr 


EE 


K CC 


te te te te 


te 


< 


a 




u. 


x => 


o 


a 5 


r> D 3 3 


O 


o 


3 


3 


Ul 


> 1- 


t- 


K H K 1- 


1- 


o 






X U 


U 


r u 


uuuu 


o 


-1 


Z 


Z 


UJ 


0. < 


< 


< 


< < < < 


< 


to 


u 


Ul 


t- 


to te 


cc 


x te 


te te ce te 


te 




0. 




< 


< u. 


u. 


u. u. 


u. u. u. u. 


u. 


a 


o 


o 


-1 



a)i>«oiO''nri«is(DD(M , )<onoooo«<x<4Mninso«<o 

>0<NNNtDtDtDtDtD*tDtO'O^J'«0'Nts.NNr > «.NNf>>.Nt>*»tD 

MMMMMMMMMMM^-^nntDthOOOOOOOOOnNNO 

«>nnnnnnr>tf)«>NNNNNNNtD00 0Da)C0CDtDO}CDCDtDtDC> 



l o 










o 










1- 






X 






< 


CD 






CO 




UN 




< 






z 






u 


to 


CJ 




5 


=> 




o 


to CO m 






CO 


M 


to X 


s 


s 


u 






< 


x 


Ul 


o 


2 










< Ul 


O O Z 








to 


m K 


1 -1 


z 








_l 


ce 




z 


z 


cc 




UJ 


z 




z 


z z o 


1- 




CO 


o 


10 




M 


Ul 


2 






D 


i 






!= 


< 


z 


a. 




z 


X 


o 


CO 


< 


z 


O -1 


!o 


1- 


-1 






to 


Ul 


M 




CO 


CO 








u 


to O X 


© X o 


Z 


o 


1- 


M 


te O 


1 Ul 


to 


a. 


a. 


< 


D 


_l 




> 


> 


CO 


z 




_i 


UJ 


o x to 


tc CO UJ CO 




z 


co 


UJ 


uj ce 


1 Z 


< 




to 


Ul 


X 


a. 


to 


CO 


CO 


o 


o 


J 


< 


z 


Z D « 


O m z Ul 


u 




o 


H 


a <_> 




M 


o 


UJ 


X 


«J 




< 








X 


< 


te 




UJ z 


ZLJ 


Ul 


z 


0. 


o 


M M 


1 o 


a 


Ul 


tc 


u 


Z 


x 




a. 


0. 


3 


D 


ce 




< 


< z < 


< < 03 


z 


o 


> 


te 


to X 


I M 


Ul 


2 




< 


o 


to 


a 


CO 


CO 




uj 


M 




M 


M Q. © 


■-« o x to 




M 


X 


CL. 


o 


1 -1 


r 




□ 


tc 


cc 


< 


Ul 


Ul 


Ul 


to 


z 


> 




z 


Z te 


z tc 1- to o *- 


to 


en 


\ 




x tc 


< 




O 


ui 




CO 


_i 


X 


ce 


cc 


M 


a. 




< 


□ 


O JO 


O O H 3 111 III 


o 


o 


t- 


te 


Ul < 




o 




2 






0. 








1- 




1- 




X 


X < 


X 3 O Z < 


Ll 


u. 


CO 


< 


X -J 






-1 




o 


o 


o 


o 


o 


o 




_J 


> 


z 




D <J •■ 


3 - 1- 1— CO U 


u 


Ul 


_J 


o 


i > 


2 




O 


Ul 


UJ 


Ul 


UJ 


Ul 


Ul 


ui 




u 


UJ 


UJ 


Ul U < 


Ul < < < < u 


M LJ 


Ul 


o 


o 


X Ul 


i te 




X 


M 


z 


z 


z 


z 


z 


z 


X 


te 


z 


D 


z 


z o - 


Z m m X X U CO 




z 


UJ 


_J > 


i < 


-J 




_J 
















M 


> 


J 


a. 


a. (j z 


IZZUUh 


O _l 


_l 


o 


> 


Z> -J 


i Q 




£i 


e 


z 


z 


z 


z 


z 


z 


< 


> 


to 


u. 




o o 


OOUJC0C0XI-< 


< 


u 


-1 


0. < 


z 




2 


x 


o 


© 


a> 


© 


© 


© 


tc 


o 




z 


_i 


_J X X 


oxo>>-oioce 


ce 




< 




1 o 




O 












M 






z 


a. 


M 


< 




zd_ixxzud 




X 




O X 


i <-> 


u 


u 


o 


z 


z 


z 


z 


z 


z 




Ul 


to 


te 


cc 


te uj ui 


OUILlCLClOOOUJ 


UJ 


_l 


_l 


— _l 


1 ui 


UJ 


Ul 


UJ 


Ul 


Ul 


UJ 


UJ 


UJ 


Ul 


u 


Q 


UJ 


< 


M 


« Z Z 


CCZZXXCCtO_l 


_l 






O D 


I to 


to 


to 


to 


m 


m 


ra 


eo 


m 


BO 


< 


< 


cc 


a. 


> 


> cl cl 


aao. > - i UJUJm<Q. 


CL 


Q. 


0. 


M Q. 



o 


M 


cm 


n 


r* 


n 




r» 




O 




O 




CM 


CD 




O O CD CD 


t> 


o 


- CM 




N 






CM 


N 


CM 


CM 


CM 


CM 




© 


O 


O 


O 


o - n 


(T»>0ts.CMtM*»H — 


~* * 


o 




0- 


o- 


9- 


0- 
















(D 


00 


to 


tD 


CD CD CD 


CDtDCDO^O^O^O^ 






M 






T=fl 




0* 




CM 


CM 


CM 


CM 










<* 


* * * 






m 


in r) 





X 






X 


2 


X 


Q 


to 


u 


< 


aC 


Q 




til 


UJ 


X 


Z 




O 




0. 


UJ 


3 








CD 






_j 


03 


X 


Z 


o 


X 


5 


*■* 


»- 


3 


z 


< 


u 


X 


O 


1 


1 




i 


1 


1 


> 


> 


Ui 


OC 






»- 




1 


< 


% 


% 


M 




> 




_l 


-I 


> 


> 






i 


3 


< 


< 








O 


u 




> 


i 


o 


□ 






< 




z 


Z 


3 


3 


u 




o 


o 


O 


© 


o 






z 


z 


Z 


z 


I 


§ 




3 




3 


•J 


-1 


-1 


-1 


-1 


_l 


03 


CD 


a 


03 


OB 


OB 






»- 








* 




«0 


o 




o» 


«4 




«< 


01 


M 





x 


x 


x 








2 














2 




X 








































O 


O 


a 


a) 








X 




X 


K 


o 


< 




X 


Q 


X 




UI 




z 


























X 










UJ 




X 




Q 


X 


O 


CD 


UJ 


X 


I 


a 




Q 


C0 


a. 




ac 


X 




X 


H 






z 










o 


<: 


Z 


□ 


¥- 


a 


K- 


u 


< 






Q 




UJ 


a. 


UJ 






►» 




UJ 


CO 


X 


Z 


Q 


X 


Q 


CD 








X 




X 


t- 


Ui 


X 




oc 








UJ 


X 




□ 




o 


»- 


CO 






o 




O 


»- 


I 


< 






Q 




Ui 




X 


z 


a 


X 


a 


cn 


a. 


UJ 




(J 




0) 






UJ 


2 










2 


o 


2 


o» 




K 






x 




o 




o 


1— 




< 






Q 




UJ 


10 






u 


M 




co 




< 


U 


_l 


CD 


X 


3 


z 


< 


u 


u 


CD 


X 


1 


UJ 


X 


OC 


K 






UJ 


X 




o 




o 




z 


o 


< 


X 


1 


X 


o 


z 


o 


X 




3 


M 


h- 


1 


1 


X 




l 


M 


(- 


CO 




< 


o 


_J 


10 


I 


a. 


UJ 


X 


a: 


(- 








2 


X 


1 


> 




1 




z 


UJ 


X 


(J 


X 


O 


CD 


CO 


UJ 


X 


CD 


X 


o 




o 


X 




D 




K 


to 


<t 


u 


-J 


£0 


X 


1 


1 


UJ 


»- 






t— 


1 


1 


1 


1 




1 


1 


M 


t-> 


1 


1 




1 


1 


CD 


z 


UJ 


X 


U 


X 


Q 




o 


X 




=> 






X 


X 


1 












0) 


01 


CD 


CD 


CD 


CD 


CD 


CO 


CD 


CD 


CO 


CO 


CO 


< 


1 


1 


1 




1 


1 


I 


z 


Ui 


X 


(J 


X 


O 


< 


< 


X 


> 


> 


> 


> 


§ 


3 


3 


3 


3 


3 


3 


O 


o 


o 


O 


o 


o 


o 




1- 


»- 


H 






t- 


i 


1 


1 


i 


1 


1 


1 






OC 


< 


< 


< 




X 


X 


X 


X 


X 


X 


X 


oc 


oc 


oc 


0C 


oc 


oc 


oc 


o 


o 


u 


u 


U 


O 


O 


< 


< 


< 


< 


< 


< 


< 






o 


a 


u 




o 




u 


o 


o 




(J 


cj 


03 


03 


03 


03 


03 


00 


03 


UJ 


UJ 


Ui 


UJ 


UI 


UI 


Ui 








« 












X 












z 


z 


Z 


£ 


Z 


Z 








« 






t— ( 


M 




M 




M 


M 


« 


z 


z 


z 


z 


z 


z 


z 








3 


3 


3 


3 




□ 


o 


o 


O 


□ 


□ 


u. 


LL 


Ul 


U. 


U. 


u, 


u. 


X 


X 


X 


X 


X 


X 


X 


o 


o 


□ 


o 


o 


o 


o 


Q 




o 










oc 


or 


0C 


or 


0C 


oc 


oc 
















u 


u 




u 


o 


u 


o 


X 


X 


X 


X 


X 


X 


X 






X 


O 


O 


O 


O 


a 


03 


03 


03 


03 


03 


03 


o 


o 


o 


o 


O 


o 


o 


z 


z 




z 


z 


z 


z 






z> 


D 


z> 




z> 


E 






z 




z 


z 
















z 


I 


z 


I 


z 


z 


z 


o 


o 


□ 


□ 


□ 


o 


o 




UJ 


UI 


Ui 


Ui 


Ui 


Ui 


Ui 




UJ 


3 












u. 


fe 


h 


u. 


u. 










3 




z> 


cc 


ac 


cc 


OC 


cc 


K 


oc 




z 


z 


z 


z 


z 


z 


z 




z 


-1 


-1 


-J 


-1 


fa 




o 






o 


o 


-1 


-1 


-1 




-1 


-J 


-1 


03 


03 


03 


03 


03 


03 


a 


a. 


a. 


a. 


a. 


a. 


a. 


a. 


a. 


a. 


GL 


03 


OB 


OB 


03 


03 


03 


a 


03 


03 


03 


03 


03 


03 


03 


03 


03 


03 


03 


03 


03 


03 


03 


03 


03 


03 


03 


03 


03 


03 


03 


03 


03 


03 


00 


03 


»- 




t- 


K 




t- 


t- 










t- 




1- 






t- 


»- 






1- 




1- 


K 


»- 




H 


1- 


K 






»- 


t- 






P5 




r> 


O 


o 


»4 


01 


n 




« 




o 




Oi 


n 




n 


o 


o 




r«i 


n 




r> 


<0 


O 




01 


n 


«r 




-0 


o 




CM 


01 


01 


OJ 


OJ 


n 


n 


n 


n 


n 


n 


n 
















r> 


m 


m 


in 




r> 


rs 


>0 


-0 


•o 


-0 






■0 









ooooooooooooooooooooooooooooooooooooooooo 







Z x 




X 


»- 




X 




X 


X X 






X 


z 


X 


X 


X 


H 






z 










Z x 


X H- 








« 


i X at a 


X 


Q 


(0 


o 


< 


z 


Q 


Q a 


CD 


CJ 


< 


ac 


Q 


Q 


a 


to 






a£ 


X 




X 


1- 


X aC Q 


X Q CO 




X 






i u < z 


Q 




UJ 


UJ 


X 








UJ 


UJ 


X 


Z 








UJ 




X 


z 


Q 


X 


Q 


cn 


O < Z 


Q UJ 


U 


< 






1 Ui x Z) o 




O 


»- 


OL 


UJ 


Z 


O 


H O 


1- 


0. 


UI 


D 


o 


1- 


o 


f- 




< 






Q 




UJ 


111 x D O 


O H 


LU 


X 






1 < 0. UI oc 




t- 




CD 






OC 


_J K 




CO 






oc 








UJ 


X 




o 




O 


i- 


ol ui oc 


K K 


a. 


UJ 




c 


1 m CO CO X o 




10 


X 


z 


□ 




o 


D 10 


X 


z 


o 


X 


o 




CD 


X 


0. 


UJ 


X 


oc 


1- 


K 




CO X o 


j tn I 


tn 






UJ 


I2DZOXM 




i— < 


1- 




2 


X 


» 


O <-• 


»- 




z 


< 




(J 


i-i 


1- 


CO 




< 


u 


-I 


10 


I 


Z O x « 


3 ^ K 


z 


o 






IOU3ZUII 


O 


X 


□ 


1 


1 


< 


X 


1 X 


o 


1 


1 


X 


X 


1 


X 


o 


z 


o 


X 


t 






K 


3 Z UI X U X o 


3 


z 






I X U 1 1 1 1 


1 


1 




> 


> 


X 


1 


> 1 


1 


o 


o 


UJ 


1 


o 


1 


1 




z 


UJ 


X 


o 


X 


o 


1 II 1 


1 1 1 


1 


1 




• 


1 3 CD x x x x 


X 


X 


X 


CO 


CD 


UJ 


CO 


CO CD 


(0 


UJ 




1 


o 


UI 


u 


CJ 


i 


1 


1 


1 


1 


1 


1 


oc oc oc oc 


oc oc oc 


CC 


QC 




4* 


1 UJ 03 UJ UJ UJ UJ 


UJ 


UI 


UJ 














z 




o 


UJ 


z 


UJ 


UJ 


CD 


CO 


CD 


CO 


CD 


tn 


CD 


1- K K K 




< 


< 




« 


Z< J J J J 




_l 


-1 


oc 


OC 


oc 


oc 


oc OC 


oc 






UJ 


z 




z 


Z 


O 


o 


o 


o 


o 


o 


O 


_l _l _l _l -I -I _l 


_) 


_l 






L 0. 0. 0. 0. 


0. 


0. 


0. 






3 








03 


03 


z 




03 






z 


z 


z 


z 


z 


z 


z 


►—<►"-«>—<»—< 


»—«►—»»—« 


3 


3 


* 


> 




X 


X 


X 


UJ 


UJ 


UJ 


UJ 


UJ UJ 


UJ 


K 


K 




03 


»- 


03 


CO 
















u. u. u. u. 


U. U. LL 


Q 


O 




m 


< z § § o o 


o 


o 


o 


_l 


_l 


-1 


_l 


-1 -1 


-J 






00 






1- 


1- 


00 


03 


00 


CO 


03 


00 


CO 


z z z z 


z z z 


O 


o 


m 


u 


IJDUUUU 


u 


o 


u 


0. 


0. 


0. 


0. 


0. 0. 


0. 


O 


o 


»- 




o 








1- 


1- 


1- 


1- 










Z 


z 


O 1 


A 


1 -J -1 




















o 


o 




o 


o 


o 


o 
















o o o o 


C* O C9 






c 




1 UJ OB OB 03 03 


03 


00 


03 


03 


m 


03 


m 


03 03 


03 


oc 


oc 


oc 


oc 


CC 


oc 


oc 


> 


> 


> 


> 


> 


> 


> 


© 


o 


« 1 


< 






1- 


1- 


1- 


t- 


t- 


H 




1- 


0. 


0. 


0. 


OL 


0. 


0. 


CL 


oc 


oc 


CC 


oc 


CC 




CC 


z z z z 


z z z 


z 


z 


« 




1 O M 


































< 


< 


< 


< 


< 


< 


< 


3 D 3 D 


3 3 3 


3 


3 


Q 


< 

X 


1 X 03 X X X X 


X 


X 


r 


X 


X 


X 


X 


X X 


X 


X 


X 


X 


X 


X 


X 


X 


X 


X 


X 


X 


X 


X 


X 


1 1 — ( — 1 


_l _l _l 


_l 


-1 




a. 


1 < X oc oc oc oc 


oc tr cr cc 


oc 


CC 


CC 


CC oc 


oc 


oc 


tr 


oc 


oc 


oc 


CC 


Ct 


CC 


OC CC oc oc 


CC 


CC 


CO CO DO 03 


03 03 00 


CO 


CD 


tH 




1 CO < B. 0. 0. 0. 0. 


0. 0. 


0. 


a. 


OL 


0. 


QL OL 0. 


0. £L 


Ol 


0. 


Ol 


CL 


ol a 


a. 


Q- 


CL 


CL 


0. Ol 


1 — »— f— 0— 


K-l- 


1- 


1- 



X 

Z Q 

z a 

3 OC 
cj 

X ~ 

< X 

x I 

uj oc 

I < 

-I _l 

3 3 

a q 

o □ 

z z 

o o 

z z 

3 3 

_J -I 

03 03 



o^oin*r>^)o — ojr)*«'00-«oin* 



KHO"Nr)*0'00'<Nn»iO'00'<flir) 
f^<oobooob''-'•<•-'•«''"<lIl(DO)(DODllHD(^CM^(^l^^^l^ooooooo-' < - , '" 

"OOOOOOOOOOOOOOOOOOOOOOOO^^^** — ^^ — — — 



n "0 o o o o 

ooooooooooooooooooooooooooooooooooooooooo 



329 



I 
I 

C I 
O I 

4* I 

a. I 

— I 
u l 
*j i 
m I 
• I 
O I 

I 

JE I 

m I 

— I 

— I 
w I 
C I 
UI I 

I 

■o | 



m i 

— i 
> i 
• 

w l 



« l 



UJ 


UJ 




CD 




03 






< 


















O 


















£ 












01 


O 
















s 














CO 












a** 


w UJ w 


o 


a 




< to 




o 


a 


S 


Z 






cn 








5 


z 


3 


z 


UJ 


o 


E 


E 


u 


cn 


3 


z 


UI O Ui 


< 


<£ 




m CD 


CO CO < 


> 


2 


o 


2 




1 








< 


2 


3 


_J 


3 


z 


z 


3 


3 


UJ 


2 


2 




z z z 


xt- J 




to 


E CO 3 


o « « < < 


£ 




2 


2 






K 




2 




U 


=! 




_J 






UI 


UI 


z 


2 






O (0 CL 


a. 


o < 


UI tm h- 


UKZmm o 


O 


UJ 


3 


2' 




<J 






2 




z 




UJ 




a 


o 


-1 


_l 






1- 


05 


£ £ E 


UJ 




z « 


1- CO E U CO 


> m O z z z 


Q 


s 


UJ 


tjj 






2 




UI 


o 


o 


UI 


CD 


UI 


2 


2 


E 


E 


< 


< 


cn 


< 


3 3 cn 


OHO 


2 


£ x 


O CO UI UI o 


£ Z £ O > 3 




E 


z 


Z 




—1 


2 




c 


4 


E 


IS 


o 


09 


3 


3 






E 


E 


< 




Z Z UI 


f- >-> 


z 


Ui UI < 


< 3 E Z Z 


O O 3 £ a CJ> _J 


O 




a. 


E 




: 


2 






K 




o 


_J 


o 


_l 


-J 


-1 


_i 


3 


3 




P 


« -i tr 


co x z 


2 


dee 


Oh< 


Z £ W 3 O Z 


M 


CO 








2 


2 






1- 




2 




-1 






€ 


2 


UI 


UJ 


a 


UI 


1-4- -v 


« t- o 


3 


< x 


O E E I I 


« 3 Z UJ E 3 U. 


Q 




(S 


m 


S3 


2 


yj 


CD 


a 




z 




UI 




I 


X 


1- 


E 


2 


_l 


UJ 


2 


CD CO x 


i o r 


2 


_i 5 z 


uuoo 


t- UI E Z 3 _l 5 


C=I 


1 




M 




2 


2 




f» 


□ 


£=3 


E 


-I 


E 


u 


u 


Ul 


UI 


(2 


E 


s 




< < < 


i 1 3 


2 




O Z E UI 


U 


u 






CO 


© 


2= 


5 






< 


UJ 


a 


UJ 


2 


z 


[=i 


u 








1- 


M M CC 


uuu 


a. 


a. t- < 


< E CO _J U. CO 


u 






i 








o 


»- 




E 


E 


Q 


2 


Q 


□ 




cn 


-J 


_l 




05 


a a o 


UI Ui z 






< < u u 


UiUllOM 


□ 


£ 


£ 






U 


2 




u 






EL 




2 


E 


E 


% 


« 


E 


E 


z 


O 


UI UI I 


z z a. 


> 


o > >■ 


> _l -I 


><_!«-■ CD 




CD 




CD 


2 


O 


£ 


n 


UI 




O 


3 


£ 


_l 


69 


SB 


E 


> 


a 


O 


< 


E 


£ £ 1- 






■-■EE 


E _l _l O O 


E _l CO CO y CD < 




< 


<C 


<€ 




2 


CD 


> 


u. 


z 


UJ 


















UI 






cp a > 


< 


Z < < 


< UI UI z z 


< .J < □ M M M 


> 


•J 




<J 


Z 


u 


< 




u. 


< 


z 


O 


O 


O 


a 


o 


o 


o 




2 


a 


O 


O O O 


t- H E 


a 


o z z 


Z(-h«M 


Z UI 111 I E J Q 




E 


E 


E 


o 


Q 


_l 


□ 


UI 


z 




UJ 


UJ 


UI 


UJ 


UJ 


UI 


UJ 






UI 


UJ 




< 


2 




O UI Ui E E 


O CJ £ K UI « « 


< 


o 


2 


O 




Z 


E 


2 




9 


o 


z 


z 


z 


2 


H 


z 


Z 


o 


O 


z 


z 


z z z 




□ 




X Q Q O O 


£ •-« i- « a i a 


£ 




h- 


t- 


< 




2 


3 


UI 




KM 
















M 










0) 0J <-■ 


U 


UI _l _l 


_l E E O O 


_l E CO Z « E Z 


i— < 


05 


33 


n 


E 


2 


X 


UJ 


1- 


_J 


«J 


-J 






_l 


_J 


-J 


_j 


-J 


«J 


_j 


-J 


_l -1 -I 


UI Ui E 


UI 


Z 3 3 


3 O O I I 


5 < O E E > < 


E 








< 


o 


O 


Z 


< 


< 


2 


< 


< 


< 


< 


< 


< 




< 


2 


s 





< < < 


EEL 


CD 


o. a. a. 


E 03 SB 3 3 


E > E O UI CO <J 


E 


I 


I 


X 




UI 


!= 


E 


_l 


£ 


£ 


£ 


£ 


£ 


£ 


£ 


£ 


£ 


£ 


c 


£ 


£ 


£ £ £ 



o 



ocDn*npi»<oo»<iBB'--»<o»"-*oO''ff'fliH*noo 
nnooox N — nnnno k ri(ion*tf)CM»r>ion-«tMO'ONCM 
*-mriifiirininnnnnnnnNS»'-H».»4»«nininr)n'0 

OOOOOOOOOOOOOOOOOO — — — — — ^-o*- — 



'OO'O'O'O'O'O'C'O'O'0'0444 



X 

a x 
a 

o 

E *- 
U -J 
3 
£ U 
I I 
X X 

< < 

E E 

□ O 
I I 



X CO £ 
O UI u < 
h UI X 

E UI 
1= 2 ffl 

CO H Z O 
i-> D 3 Z 

1 I I I 

I x o O 
X < Ui UI 
<£ E Z Z 

□ O 03 OB 

I £ H H 



* X 

z a 

£ E 

< CJ 

X >■* 

Ui £ 

I I 

u o 



OOOO>>0B03 

§£ £ £ E E H K 
3 3 3 < < 
UIUIUIUIZZZZ 

zzzzogoo 

EEEE££££ 

oaeanoB3333 

HI-t-KEEEE 



X 

x a 
a 

o 

^2 

O I 

I I 
u u 

UJ UI 

z z 

A 0B 



z z 

o □ 

£ £ 

-J -I 

3 3 

E E 



£ 

u < z 

»- Ui X * 

CD E UI Z 
Ui CO 3 

t= s c 

3 Z £ 

I I I < 

I- to to x 

□ Q O 111 

I Z Z I 

u to 

UJ 09 09 O 
Z »- H Z 

CD >- >- 09 
K E E H 
2 2 

z z z z 

O O Q O 

£ £ £ £ 

_J _l _J _i 

3 3 3 3 

E E E E 



X 

Q x 

a 

o 

E t- 
U _l 
«- 3 
£ (J 
I I 
CD CD 
O O 

z z 

09 09 
K H 

z z 

o o 

£ £ 

-I -I 

3 3 

E E 



X H 
Q CO 
UI 

H 

»- O 
CO X UJ 
I- E 

1 O CO 
I I z 
05 05 3 

o a i 

z z ^ 

to 

B ffl « 

H H E 
3 

Z Z UJ 
O O — I 
£ £ E 
_) —I 
3 3 03 
E E H 



Z 

sC 
£ Z 
< 3 
x 

UJ £ 
< 

x 
Z Ui 

1 I 
> > 

CO 05 

E E 

3 3 
UI UI 
-I -I 
E E 



X 

D 

X O 
Q X Q 
£3 _l 
O □ 
E H H 

^£ 
IUI 

I I I 
> > > 
CD CD CD 

H H H 

E E E 

3 3 3 

Ui UI Ui 

1 I — I 

E E E 



U Z 

UI ae 
el 2 2 

!= 2 « 

05 3 UJ £ 

UI I < 

K 05 O X 

Hi 2 UI 

i a i i 
h o UJ ui 

Z Q O 

1 O O 
> O z z 
01 — 

>-i U x x 

E < < < 

3 E E E 

2i Q o e 
_l X I I 
E H »- I- 



090909090309090909 
KHKHHI-l-t-H 



X X 

q x a 
o 

o 
« t 

U _l 05 
« Z) « 
£ (J X 

1 I I 
Ui UI Ui 

a a a 
o o o 
z z z 

XXX 

< < < 

E E E 

O Q O 
XXX 
H K H 

09 09 09 
H H H 



I- O 
CO UI 
UI E 
H CD 
Z 
X 3 
h- I 
O 03 



□ < 
Z UI 
X 
x y 
< < 

E E 
O H 
X 

»- _l 
□ 
m cn 



£ x 

< Z O 
x ^ 

UJ z o 
3 E 
O U 
Z £ « 
I < £ 

03 X I 
K UI 09 
I K 
_l 03 

< K X 
UJ U 
X X < 
O U E 

< <t- 
E E 

—J —J —J 

o o o 

cn cn cn 



XXI- 

e q cn 
ui 

K O H 

3 05 X 

O « I- 

I X O 

03 I I 

K 03 03 



< X X 

UI u u 

X < < 

O E E 

< I- H 
E 

H H H 

< < 

I — » — I 

o o o 

CD CD cn 



SooooSo5S35ooS3ooSSoSooSo3ooooo3oooooooooooo 



z 






aC 


X 




£ Z 


a 


X 


cj < 3 




a 


UJ x 


o 




E UI £ 


tx 


t- 


cn < 




_i 


Z O x 




3 


3 Z Ui 

1 1 1 


£ 

1 


(J 
1 


ouo 


(J 


U 


UI UI Ui 


UJ 


UJ 


z z z 


2 


2 


03 03 09 


00 


a 


t-l-h 




i- 


E E E 


E 


E 


05 05 05 


03 


cn 


UI UJ UI 


UJ 


UJ 


E E E 


E 


E 


O — CM 


F3 


* 


03 CD CD 


CD 


CD 


CM CM CM 


CM 


CM 


H «H *H 






o o o 


O 


O 



330 




u u o 

<. < < 

ce ce ce 

U. U. U. 



***i)iniftininifinnnniofiiofii()nininftnnfiiftinfi(nrt^^^ggg 





o 




o 












to 












< 


0) 


z 


CO 


to 




CO 


z 


z < 




o 


to 












< 






< 




o tn 


o 


UI 


U i-i 


01 


o 






§ 


Ui 


o 






u 


£ 


o 






< 




z 


UI O Q 


3 


CO 01 


UI t- 


M 


z 


_l 


Z 3 UJ 


-1 


z 


z 






Ui 




cc 


z 






z 


o 


z z 


O 


m o 


z - 






x O 


M 111 Z U 










< 


z 


£ 


< 


□ 


M 


z 


o 




-J 


CJ 


X 01 o 


z 




r 


H -1 « 


to 


to 


to 




tt 




to 


u. 


£ 


z 


o 


£ 




< < u 




< o > 


0) o 


z 


ui 


< UI 


tniLu< 


3 


> 


>- 


o 


3 


0. 


< 


z 


3 


o 


£ 


3 


UI 


M 2 


CL 


CC -1 E 


« z 


u 




ce z 


< ID « UI 


I 


to 


0) 


z 


Ui 


to 


-i 




UI 


£ 


3 


UJ 


z 


z z « 


o 


X _J 


Q O 


z 


to 


□ 


h O Ql K I 


u 






3 


_i 


ui 


0. 




z 


3 


UJ 


z 


CL 


o o 


o 


H- « CO 


CC 


o 


> 


z o 


o ui cc o u 


z 


CL 


0. 


-1 


0. 


ce 


o 


£ 


(L 


UJ 


z 


CL 




£ £ O 


i 


z o > 


K CO 


cc 


to 




Ui Z I < 


o 


tn 


to 










to 




z 


0. 




_i 


3 3 UI 




< cc to 


o 


CO 




_l 


£ OhE 


oc 


Ui 


UJ 


o 


o 


o 






UJ 


0. 




-1 


< 


UI Ui £ 




UI 


UI cc 


o 


0. 


-I < 


O UJ < t- 
O h ZC 


m 


ce 


CC 


Ui 










< 






< 


o 


Z Z O 


z 


Z CL z 


z5 


CC Z 


to 


OL £ 








z 






> 


5! 


>— < 


-J 




o 




CL 0. H 




«-> co i- 




Z 3 


UJ 


□ 


Ui -1 »- D 


3 




3 








ce 


m 


z 


< 




o 




> 




< o 




O -1 


CC 


Ui > 


Z<OZh 


1- 


1- 


1- 


> 


> 


> 


o 


£ 


o 




z 


o 


O 


JJU 


< 


< 


-J 






Z CC 


£ M M M 






»-* 


< 


< 


< 




UJ 










o 


< < 




<-> z z 


Z 3 


H » 


o 


< 


-1-10) 


to 


to 


0) 


I 


I 


i 


< 








S 




-I 


M H 3 


z 


z *-> 


M CC 


U 01 


UJ 


Z Q 


< Q < < 








Ui 


UJ 


UJ 




Z 


UJ 


o 


_i 


\— 


> 


CC K 


o 


o 

* £ r 

3 5 3 


3 


3 CC 


z 


o z 


r i r §5 


z 


z 


z 


m 


CO 


CD 


< 


o 


z 


Q 


u. 


CL 


I 


Ui UI £ 


£ 


£ CL 


CC UI 




M O 














CL 


£ 


(L 


3 


z 


UJ 


CL 


t- 1- 3 


3 


3 O 


f— £ 


— i 


_l o 


UUUi 










u 


O 


CO 






UJ 


»-* 


CC 


4 


U O LI 


UI 


UJ UI UI 


UI U 


CO CC 


< 


< Ui 


Ui Ui Ui « < 


< 


< 


< 




z 




UI 






to 




h- 




< < Z 


z 


z z z 


Z 3 


CD < 


z 


z to 


to 0) 01 -1 O 


o 




u 


3 


2) 




cc 


CL 




CL 


I 


10 


to 


cd co a. 


a 


CL CL CL 


0. £ 


o u. 



o 
z 

3 



to 
cc 
UI 

01 

o to 

to z - 

< CO 

01 u. o 
to i ce 

4 Q UJ 

O CC CO 

< M 3 

o m co 



93m 

Z -I Z 

3 O 

—J - £ 

a> to 3 
z - cc ui 
5 to cl z 

_l CC CL CL 

UJ - 
* * cc = 
to CC I- Z 
cc O to O 
UI 2 I h 

i ^ I- 

CC £ cc < 
O O < — I 
30OH 

hz-iz- 

-I 01 OL UJ 



£ : 



0--. o-Nnw^mcoc'-MDa-"' - o — Mn*coch-"nr)-or>CD — mo — rv n «f m -o r^. 
r>niv|^|v.r^< — — — — r>r>nc>inttr*nirvioinjf¥<r«r*r'>r«f«f'- — mmmmmmmm 
'OiMMMMh^nnnnnnnn^cocoiDiDiiicDoisaD cd<d tDCD^thO v c*-0'0 > '() > -Of'0*'0"' 




-«rno-«N -< r — j> 



Q 








z 






UJ 










z 


UJ 


z 


Z 




UJ 


Z 




05 


z 


Q 




_l 


EL 


CD 


Li 


UJ 


z 


OL 


UJ 




o 


UI 


UJ 




U 


O Q 


O 


0. 


EL 


UJ 


□ 


EL 


z 


_J 


EL 


CB 


Z 


1 


1 UI 


-1 


O 


O 


EL 


1 


□ 


UJ 


o 


Q 


□ 


UJ 


EE 


EE 05 


(J 


1 


1 


o 


CO 


1 


EL 


1 


1 


-I 


£L 


□ 


O □ 


1 


m 


03 


1 


CD 


05 


□ 




X 


u 


O 


X 


X _J 


n 


CD 


CD 


tn 




CB 


1 


< 


< 


1 


1 




H- U 


M 






CD 


EJC 


*H 


05 


or 


EE 


X 


X 


□ 


a i 


K 


EC 


K 






EC 


O 


o 


□ 


< 


< 


E 


E 05 








EE 


Z 




z 


z 


I 


EE 


IE 


UI 


UJ □ 


UJ 


EE 


UJ 




UJ 


UJ 




t- 


H 


□ 


□ 


X 


X z 


ee 


3 


> 


X 


> 


EE 


05 


o 


Q 


I 


X 


□ 


o 


1 o 


□ 






UJ 


□ 


CD 




E 




t- 


E 


E > 


E 


u. 


u, 


CD 


en 


E 








□ 


o 




3 EE 


1 "s. 












EE 




UJ 


E 


E 


UI 


UJ 3 




UJ 


UJ 


UJ 


UJ 


(- 






z 


UI 


UI 


z 


Z "J 


Z 


IT 


tr 


ee 


cc 


X 


t- 


O EL 


EL 


X 


X 


£L 


EL Z 


1 o 


3 


3 




3 


c* 


















H 


H 




t- 




5 


-1 E 


E 


E 


E 




E 


1 UJ 


O 


u 


o 


o 


UJ 


E 


3 


=> 


3 




3 


3 O 


< 


< 


< 


< 






« < 


< 


< 


< 


<£ 


< Z 


1 x 


tr 


E 


tr 


EE 


X 


X 


-J EE 


CC 


EE 


EE 


EE 


EE 3 


1 IL 


L, 


U. 


u. 


L, 


u. 


u. 


U. 1- 






1- 




t- _J 



CD 






«0 






0>- 












o 


O 














<* o 




CM 


n 




in ru 


N 


N 




N 


N 


N 




N O 


o 


O 


o 


o 


o - 


O 


O 


O 


O 


O 


O 


o 


O -0 


-0 


«0 


•a 


-0 


-0 < 


CD 


CD 


CD 


CD 


CD 


CD 


CO 


CO CO 


CD 


CD 


CO 


CO 


CD CO 



r 

§ 
z 

80 
< 

>» 

oc 
< o 



2!; 



2* 

a. oe g »- x 

S- 5 I £L OC 
L H O O O 

oc ui »- o ui a 

OKOUX< 



MO" 

2 2 2 2 2 5 -*2 4N9»-' < N' < n5ooN4nt«t«o«fo>N 

i*iH*ilffffmstttff3iizttig* 




z 

O O Q 

m ui Ui 
H 0) tO 
U O O 
< J _l 
liiuu 
ce l i 
a) a 
t- o ►* 
to Z 0C 
Ui 

HJBUJ 

z oe □ 



o to 

UI O Q 
CD _l Ui 

o v to 

-I i o 

z _i 

1 z> u 
0) z 
m oc 



«U5 
E h 2 
09 0C 
O Ui 

& co 



_f Ui UI UI UI K 

5 oe oc or oc < 

O 3 3 D 5 o 

Uuuuu J 

CO < < < < tD 

D oc or ce ec « 

l- U. U. U. Ik o 



CO 



z 
to oe 
m u 
« »- 
oc to 

z z 

< < 

oc oc 

to 8s 

















< 


or 






< 




UI 


CO 


T. 


< 






UI 




z 


o 


hi 


-J 


-1 


u 


X 


CO 




z 


CO 




<. 


UI 


u 




o 




> 


U 


z 


z 


< 


i 


z 


UI 


I 




or 




or 


u 


=1 


UI 


0. 


> 


UI 




t- 


z 


-1 


ce 


r 


< 


»- 






o 


>«. 




Ui 


-1 


CO 


z 


z 


ce 


I 




o 


o 


or 




CD 


o 


> 


z 


o 


or 


UI 






z 


or 


< 


z 


o 


K 


> 


> 


o 


O 




or 




CO 


o 


Q 


or 






UI 






o 


O 


m 


< 


<-> 


f- 


z 


u. 


CD 


CD 


\ 


or 


CD 


to 


u 


o 






I 


M 










z 


z 


u 


0. 


CO 


z 


z 


z 


o 


o 


< 


CO 










M 


M 


ce 


UI 


z 


< 


< 


< 


UI 


Ui 


»- 


ce 




or 


ce 


or 


OR 


or 






< 


0. 


0. 


0. 


□ 


CD 


CD 


or 


(0 


CO 


CO 


U. 


u. 


U. 


u. 


»- 



O O N * 



O — (M Of 





















X 


X 


X 


X 






CO 






CO 




u 
















s 










u 






1- 




»- 








»- 


X 










U 




o 


CO O CO UI 






! (0 


or 










UI 


o 


CO 


co 


10 


to 


co 


£ 


< 




4 


u 


CO 






Ui 


X 


UI 


O Ui o z 


to 
















z to 


Ui 




< 


< 


< 


< 






or 


or 


UI 


o 






z 


o 


z 


z z z 


o 




i ° 


CO 












z 


§ 










10 




o 




z 


or 


o 


CO 




< 




-1 


z 






CD 




CO 


o 


to 


r h 








to 




to 


< 


H 




s 




00 




»— < 


UI 


ce 


UI 


UI >> < 






i oc 


o 






Ui 


o 


to 


CO 


CO 


< 




< 






CO 


to 




X 


M 


-1 


o 


CO 


X 


to 


CO _l _l X 


r 




1 CD — 








z 


z 


— X 


M 


*— 1 


1- 


1- 






to 


< 




o 


< 


u 


Q. 




< 


CL 


< 


< < < o 


ce 




J t- O. 


o 


to 








Z U 




»- 


to 


< 


co 


< 






U. 


X 


or 




r 


CO 


UI 


< 


UI 


uiuiuxxrxz 


o 


z 


CO 


z 






< 


< 


< z 




*-* 












to 


u 




O 


r 


o 




CO 




to 


t0t0UIOODZ>< 


z 


o 


1 H Ui 




i- 




»— 1 




O CO o 


X 


X 


o 


co 


o 


to 


< 


z> 


CO Ui 


Ui 


X 


_i 


u 


I 




o 




•~ < Z Z Z K 1- 


m 




i u ce 


CO 


i-i 


1-4 


z 


z 


oc o oc 


u 


u 






"N. 




1- 






z 








CJ 


0) Q 




o 


o ui < < < < r 


< 


I- 


1 Ui 


» 


X 


X 


o 


o 


o e co 


z 




3 




3 


3 


CO 


< 


CO o 


0. 


O 


0. 


> 


z 




u. 




to > > z o 




< 


i moo 




o 


o 


z 






o 


s 












1- 


< ^ 




r 




r 


o 


1- X 


o 


r 


X«_i>><"-Z 


> 




i in m m 




z 




z> 


§ 


.. co or 


ce 


ce 


< 


< 


< 


< 


o 


co 


t- 3 


CO 




r 


o 


ce 


-- D 




Ui 


uio<aroruara: 


or 




1 D CO z 


UI 


o 


§ 


UI 


Ui 


< X 


CO 


CO 


r 


X 


r 








V 


z 


u 


< 


i- 


CO 


z z 


to 


1- 


h- X O O x < U) 


o 




1 CO O UI 


I 


or 


or 


z 


z 


~ t- <j 






X 


X 


X 




3 


3 


UI > 


UI 


z 


_i 


co 






ce 


10 


COCOOH-KUIUH 


t- 


z 


1 1 Q O 




m 


CD 


0. 


0. 


z *■« 


<J 


u 


K 


»- 




1- 






M CO 


»- 


0. 


u 


o 


< 


1- H 


Ui 


> 


> «• Z < < ID 


< 


Ui 


1 > « o 


< 










O X Ui 




M 


10 


CO 


co 


(0 


< 


< 


X 






z 


UI 


UI 


(0 to 


o 


to 


co ui < or or co co 


or 


> 


i or o x 


ce 


Ui 


UI 


_i 


_l 


r u _j 


z 


z 


< 


< 


< 


< 


r 


r 


u ce 


t- 


h- 


• 


I 


I 


< < 


ce 




isi — <-> z> Z> »f 


»— t 


ce 


1 111 o u 


i- 


»- 


i— 


< 


< 


=> Z 0. 


o 


o 










X 


X 


Z 3 


z 


Z 


1- 


u 


u 


»— < 1— t 


o 


CL 


a. (- o o. a. t- h 


CL 


UI 


! co or > 








or 


ce 


ui o r 


ce 


or 




f- 


»- 




i- 


f- 


O (U 


o 


O 


to 


< 


< 


Q Q 


CO 


to 


touiziotouuao 


to 


a 


1 CD < to 


o 


u 


o 


»— » 




z ce -> 


X 


X 


X 


X 


z 


Z 


CD 


co 


tr _i 


CL 


CL 


o 


cr 


ce 


UI UI 


i— i 


UJ 


UJ — DUJUJUJUJ—' 


UJ 


> 


1 O CO 0. 


< 


< 


< 


> 


> 


0. CD CO 






Hi 


UI 


1-4 




< 


< 


00 0. 


10 


to 


0. 


»- 




X X 


o 


or 


oc»-_icecea.auor 


ce 


I 



01 »-«•-< O »-■ CO Cf- o 

-«-of -o-oooo 

NnOO-O-OtDCDtD 



o 




o 




























0- 


0- 




o 


o 


co 




o 




w n 




CD 


n 


n 


n 


n 


* 








ID 


Ch 




ok o- 






o- 


o- 


Ch 


o- 












t-» 






















m 


r> 


r> 


m 




r> 10 







— CM p •< 
CD CD D O O 



(►P)C0C00)*< , fl'O'O 



I 

<0 



< 



o . 

■*« cl 

• . 

b o 



or m 

•m 
•U C 

3 O 

o E 

f 3 
■M « 

— c 

3 EL 



o 
o 
o 
r 



O 
cc 
a 




- o — 

V-G^O-O-OOKf^r^ODCDCD CDCDYCDCDGDCD<0 



n * 


0> 


O 




ft) 


n 






N 




o o o 


o 










m 




O 












N 


N 










0- o o 


o 


O 


o 


o 


O 


O 


n 


N 




K CD GO 


CD 


CO 


CO 


CD 


CO 


CD 


CD 


CD 


CD 



03 n 

O Qj 





X 1 




© 
















z 








4 












o 








r 


(J 






S3 






» 1 




z 






w 


to 


o 




r 


3 




to 


to 




01 






NO 




UJ 




z 


4 


4 


UJ 


o 


to 












z> 


< 


r 


UJ 


□ 


3 




3 


UJ 


< 


o 


o 


Z 


»— ■ 




UJ 




z 


u 


o 


Z 


_l 


z 


z 


a 












_J 


CC 


3 


z 




CC 




UJ 


z 




z 


z 


o 






z 


u 






UJ 


z 


UJ 


U. 




o 


z 








a> I 




\ 




Z 






t- 


< 


z 


a. 


s 






z 








O 


(J 


z 


z 


D 


£ 


z 


a 






O 


to 




C 1 




0) 


UJ 




CD 


to 


m 




CL 




o 


o 


z 


3 


X 






z 


UJ 


□ 




UJ 


UJ 




z 




a 


z 






UJ i 


4 


3 


_l 




> 


> 


CO 


2 






z 


or 


CP 


UJ 


<J> 


CD 


u 




2 


u 


> 


z 






3 


Cl 












Ul 


X 


a. 


cn 


10 


to 


O 


O 


-1 


< 


3 


□ 




z 


z 


UJ 




UJ 




□ 


X 


CL 


z 


a. 


u 


to 




u 






"C | 


I 


u 




< 








r 


< 


cc 


UJ 




z 


CL 


o 


-1 


or 


z 


z 


z 


H- 


V. 




to 




UJ 


<_> 




Z 




■ 1 


(J 


Z 


r 




a. 


CL 


3 


3 


cc 




z 


■4 


4 




cc 


00 




0> 


□ 


3 


4 


<J 


=> 


UJ 


CL 


CC 




z 


o 




*» I 


< 


□ 


to 


a 


01 


to 




UJ 




> 


CL 


M 




X 


B 




05 




u 


UJ 


CL 


Z 


CL 


or 


to 




CL 


to 


M 




"» I 


CC 


EC 


< 


UJ 


UJ 


UJ 


to 


z 


> 






Z 


cc 






to o 


09 




o 


z 


a 


o 






UJ 


ec 


to 


tn 




i 


h- 


m 


j 




EC 


cc 




CL 




4 


-I 


o 


□ 




EC 


DUD 


CO 


z 




z 


or 


o 


CL 


or 


X 


UJ 


3 


3 




> I 






CL 








:= 




I— 




4 


z 




3 


X 


O Z 




cc 






□ 


GO 


4 


3 






or 


U. 


u. 




• 


o 


□ 


o 


□ 


o 


o 




J 


> 


z 




3 






(J 




> 


UJ 


UJ 




z 








<j 






u. 


u. 


• 


t. i 


UJ 


UJ 


Ul 




UJ 


UJ 


UJ 


< 


u 


UJ 


u 


UJ 


< 


< 




< < 


< 


2C 


z 


to 


D 


or 


CC 


cc 


4 


cc 


or 


UJ 


UJ 


o 


■D 1 


z 


z 


z 


z 


z 


z 


X 


CC 


z 


z> 


o 


z 






H- 


r r 


3 


cc 


0. 


3 


UJ 


O 


o 


o 




o 


o 






c 


1, 














u 




> 


_l 


<J> 


CL 


z 


z 


u 


UJ UJ 


cc 


□ 




Q 


z 


CL 


a. 


Cl 


CL 


CL 


Cl 


-1 


_) 


Ol 


4 1 


z 


z 


z 


z 


z 


z 


< 


> 




u. 


a 


o 


o 


UJ 


3 


to to 




3 


4 




CL 


4 


4 


4 


4 


4 


4 


4 


4 






C5 


C9 


o 


0) 


o 


C9 


CC 


o 




z 


r 


u 


r 


3 


cc 


> > 


< 




u 


C5 




> 


> 




> 


> 


> 




or 




4 1 












M 


t- 


z 


a. 




3 


z 


3 


_J 


t- 


X X 




J 




or 


1- 
















3 


a 


X 1 


z 


z 


z 


z 


z 


z 




UJ 


in 


or 


UJ 


□ 


UJ 


u. 


in 


Cl CL 


or 


< 


_J 


O 


m 


Z 


5 


Z 


Z 


3 


5 


UJ 


UJ 




1 CL 1 


UJ 


UJ 


LU 


UJ 


UJ 


UJ 


O 


Q 


UJ 


< 


z 


cc 


z 


z 


CD 


z r 


X 


a 




z 


D 


D 


3 


3 




-I 


J 




1 l_> 1 


B 


09 


09 


09 


09 


09 


4 


< 


cc 


a. 


EL 


09 


CL 




o 


UJ UJ u 


u 


CO 




o 


u. 


u. 


U. 


U. 


u. 


u. 


0, 


Cl 



u 
C 


1 * 1 


n 


n 




tn 


CD 


0- 




o 




ft) 








o 


ft) 


O CD 












o 




ft) 


n 


«r 


o- 


CD 


o- 




1 "O 1 




ru 






ft) 


ftl 




o 


o 


o 




in 




r^. 




ftj ftl 


-0 


o 


ft) 


n 


»r 


•a 


<c 




o 


o 








L 


1 O i 














«0 


CD 


CD 


CO 


CD 


CO 


CD 


CO 


? 


o- Ch 


Ch 


o 


o 


o 


O 


o 


o 


o 


o 


o 


O 




^— « 


CL 


1 U 1 


f3 


N 


ru 


ft) 


ft! 


ft) 




«* 






<3" 




» 


«r 






T 


n 


in 


m 


in 


m 


in 


in 


in 


in 


in 


in 


m 



334 



X 




X 


(- 




r 


z 


X 


X 


X 


1- 






z 












£ 


z 




X 






u 
































z 


Q 






Mi 


(J 


< 




o 


O 


O 


0) 






sc. 


X 




X 


t- 


u 


< 




X 




X 




UJ 




z 


























£ 


a: 




Q 




UJ 


Ui 


X 


Z 








UI 






z 


a 


X 


o 


0) 


UI 


X 


z 


Q 




a 


to 


0. 






X 




X 








z 










V 


< 


z 


o 




o 




a. 






o 


1- 


O 




u 


< 


3 




Q 




UI 




UI 


3 




1- 




UI 


to 




2 


© 


X 


Q 


to 








x 




X 


t~ 


UJ 


X 


z> 


oc 


¥- 


1- 




to 






oc 




1- 




UI 


X 




o 




o 


1- 


z 5 






O 


_l 


o 


1- 


z 


< 


O 




Q 




UI 




£ 


z 


Q 


X 


o 


w 


0, 


UI 




u 


_l 


(D 


Z 


z 


o 




u 




03 


I 


a. 


UI 


£ 


oc 


1— 


1- 






o 


2 


oc 




i- 






X 




o 




O 


t= 




< 






o 




hi 


tn 






3 


M 


1- 




Z 


< 




u 




1- 


CO 






u 


-I 


C0 


z 




z 


<x 


o 


u 


to 


z 


1 


UI 


£ 


OC 


t- 






UI 


X 




O 




o 


l= 


z 


O 


< 


z 


u 


z 


o 


1 


1 


X 


£ 


I 


Z 


o 


z 


o 


X 


k-H 


3 




1- 




1 


X 




1 




1- 


to 




< 


o 


-I 


to 


2 


0. 


UJ 


£ 


OC 


H 


H 






z 


X 


1 


1 


t 


1 


> 


> 


UI 


1 


> 


1 


1 


3 


z 


UI 


£ 


o 


z 


o 


to 


10 


UI 


£ 


to 


z 


o 




o 


X 




=> 






(0 


< 


U 


_J 


to 


X 


1 


1 


UJ 


OC 


OC 


oc 


OC 




1- 


1 






1- 


1- 


1 


1 


1 


1 


1 


1 


1 






1 


1 




1 


1 


CO 


z 


UI 


£ 


O 


z 


O 


z 


O 


X 




D 




1- 


X 


X 


1 


< 


< 


< 


< 




I"* 


> 


M 




M 






0) 


to 




tO 




CD 


CO 


CO 


CO 


CO 


CO 


CO 


CD 


< 


I 


1 


1 


1 


1 


1 




z 


UI 
1 


£ 




X 


o 


< 


< 


X 










> 


> 


t- 


> 


> 


> 


> 




3 


3 




3 




3 


o 


o 


o 


o 


o 


o 


O 


1- 


»- 


t- 


1- 


1- 


1- 




1 


1 


1 


1 


1 


1 


a 




OC 






£ 




< 


< 




< 


< 


< 


< 


I 


Z 


z 


z 


Z 


z 


z 


oc 


oc 


oc 


oc 


oc 


oc 


OC 




o 


u 


<J 


o 


u 


O 


< 


< 


< 


< 


< 


<I 


< 


a 


o 


o 






a 






u 


> 


o 






o 


u 


CJ 


<_> 




CJ 


u 


u 


00 


03 


00 


03 


00 


S3 


m 


UI 


yj 


UI 


UI 


Ui 


UI 


UI 
















X 


X 


I 


i 


O 


o 








< 










z 


z 


z 


z 


Z 


z 


z 






M 




t— t 


* 


»— i 






*=J1 


^ 


M 






z 


z 


z 


Z 


Z 


z 


z 




h- 


1— 




z 


z 




3 


3 


u 


3 


3 


3 


3 


o 


o 


o 


o 


o 


o 


o 


u 


U, 


u 


u. 


u 


u 


u 


z 


z 


z 


z 


z 


z 


z 


o 


o 


o 


o 


o 


o 


□ 


o 


O 


o 
























0C 


OS 


AC 


OS 


oc 


oc 


oc 




















u 


o 






o 


£ 


£ 


£ 


£ 


£ 


£ 


£ 


£ 


£ 


£ 


o 


o 


o 


O 


Q 


o 


o 


O 


O 


O 


o 


00 


ao 


00 


00 


es 


00 


00 


o 


o 


o 


o 


o 


c» 


o 






z 


z 


z 


z 


z 






D 


D 








D 


D 




$ 


E 






§ 


z 


z 






z 


















z 


I 


z 


z 




z 


z 


o 


o 


o 


o 


o 


o 


o 


UI 


UI 


UI 


UI 


UJ 


UJ 




UJ 


UJ 


UI 












3 








3 




b 


u 


u 


u 


u. 






3 




3 


3 






5 


oc 


oc 


oc 


oc 


oc 


o: 


oc 


z 


z 


Z 


Z 


z 


z 




z 


z 


z 


-1 




-1 


-1 




-J 


-1 


-1 




J 


-I 




a 


o 


o 


o 






-1 


-1 


-J 


-J 


-J 


=J 


-i 


00 


03 


m 


® 


S3 


03 


© 


a. 


0. 


0. 


0. 


0. 


0. 




0> 


a. 


EL 


n 


00 


00 


00 


00 





00 


00 


m 


00 


00 


a 


00 


m 


03 


00 


00 


00 


00 




a 


00 


00 


00 


(0 


03 


El 


m 




S 


63 


ss 


a 


00 


ga 


03 


IS 


a 




00 


03 


03 


i- 


1- 


I- 


t- 




h- 


t- 


K 


1- 


1- 


(- 




i- 


i- 


1- 


1- 


t- 


1- 


I- 


1- 


t- 


I- 








K 




I— 




1- 


»- 










H 












1- 


n 




r> 








ro 


n 




r> 


o 


o 


^< 


CM 


n 




r> 


o 


o 




tM 


n 




ID 




o 






n 




If) 


o 


o 






n 






-0 


o 








— « 








V* 


CM 


CM 




w 


CM 


n 


m 


o 


o 


o 


n 


o 
















r> 




m 


r> 


in 


m 


ID 


«0 




o 


>0 




>o 




r- 






o o o o 


o 


o 


o o 


O 


o 


O 


o 


o 


o 


o 


o 


o 


o 


o 


o 


O 


o 


o 


O 


o 


o 


O 


o 


o 


o 


o 


o 


o 


o 


o 


o 


o 


o 


o 


O 


o o 




XXI- 
O Q CO 
UI 

l-OI-O 
_J I- UI 
3(010. 
U «-> I- CO 

1 X o z 
U I I D 
WOO I 

2 UI UI CD 
Z Z O 

03 Z 
I— 03 03 

1-1-00 
O I- 

o o o 
oc oc oc > 
o. q. a oc 
< 

£ £ £ £ 



Z 
3C 
£ Z 
< D 
x 

UI £ 
4 

a x 

z UI 

i i 

to CO 

Q O 

z z 



XI- £ 

Q ID (J < 

UI UI x 

i- a. uj 
h- CO 

10 X Z O 

•-• I- D Z 

X O I I 

1 i etc 
to to I- I- 
OO J J 

z z — « 
u u 

03 03 Z 2 

I— I— •-• ►-> 



>>>>>>oo 

OCOCOCQCOCOCZZ 
<<<<<<Z5D 
££££££-1-1 



X 

Q X 
Q 

O 

0C I- 

«J -I 

- D 

£ U 

I I 

CO CO 

O O 

z z 



Z x 

z 

3 O 
0C 
£ U 

X 

UI £ 
I I 
OC OC 



—J —J —I -J 



X 

x a 
a 

o 

h- (- 

-I to 
3 — 
U X 

t I 



00 03 03 03 



u u 
z z 



UJ 

a. 

tn 
z 

3 
I 

oc or oc oc 
t— < 

I —i 

»-<•—*»—< 3 
U u. U O 

z z z o 

M •-. « Z 



(JOOOUtf 

z z z z z z 

3 3 3 3 3 3 
_J _J -J —I — I -J 



£ Z 

< sC 
x Z 
UJ 3 

£ 
Z < 

1 x 
0C UJ 

< I 

—J —I 

3 D 

a o 

a o 

z z 

cs o 

z z 

3 3 

-I -I 



OC OC OC OC 
0. QL 0. 0l 



irttiriritairirtcirKirtrirtttraiioccKccctffiiBCDmcDiiaitBmtii 
n.lillQ.a(Lo.a.o.^.ll.lo.Q.la.tt.ta.ll.a.o.^-l-l-^-l-l-^-•-*■ , " 



ru o-wn*«-oO'<Nn*««oo-Nr)*in4o-Nn*ft'(!OHNn;iftjo-ni 

■«Orj*OOOOOOO'<' < --'«'<-a)(DCD(DaitD!D(MM>9'0'0'5-OOOOOOO^'<'-' 
Winn«0OOOOOOOOOOOOOOOOOOOOOOOOOOOO»- — — — — — — -* 

3>0000000000000000000000000000000000000000 



o 
u 

4* 
3 
O 



I 

•43 



(■ 
o 

« — 

k c 

— o 
a. t 

• • 

C C 

a. 

3 • 

O C 

X • 

4» > 

— tt 

3 0) 



o 
a 



3 
C 

4* 

c 
o 

o 



« 

a 



4 




UJ z 
(0Q.IL 



< (0 

M ffl 

c oi 5 
UJ t- 

K CD 0C 
XUOIIil 

< o a. 

(E B5 H < 

x o e c 

hUUI< 

z > a. a. 

5r << 

> > -J -I 

K C J J 

< 4 UJ UJ 
Z Z H K 
g O UJ UJ 

X Z o o 
a. a. on cd 




SS88888888888ooooS---~-22222:2;2:2 




> > CD CO 

0£ tC »- H 

z z z z 

o o o o 

£ E £ £ 

mi 

a. a. a. a. 



z 

* x 
z a x 
2 a 

o 
£ tr t- 
< u _j 

x 3 
UiZU 

I I I 
o o o 
UJ UJ UJ 

z z z 

09 SB CD 



< < < 

J J J J jao.La.a. 
oooooioioiocnco 
cncomtomuujujujuj 
mmmmhii icirir 



r)tnoo«Mn*r)oo-MO*«-op^(Mn*r><oo*>Nn*n<oo-fi(n*«>oO'-Nn* 
NNNNO0D0Disa)isaii>ih0'^O'>ih5oooooo*<<''<HMHMnriininnin(\iiBiD(Da)a) 

ooooooooooooooooooooooooooocoooooooooooooooo 



336 



cs 




















cj 


CD 












z 




cj 


CD 






CD 


cj 






UJ 


LJ 




D 








D 




UJ 


O 




ID 


»— • 


UJ 


< 




z 


z 




f- 




X 


to 


-1 


z 


z 


z 






1- 


z 




a 












I 


M 




o 










M 




a 


< 




*- 


< 


1- 






K 




x 


r 


r 




M 


z 


H 


< 


DC 


Z 


z 


-j 


< o 






M 


to 


r> 


d 


r> 


to 


Z 


o 








Ul 


Ul 








K 




or 


UJ 


UJ 


Ul 


o 


O 


x 


Z 




t- 




cs 








CD 




a. 


z 


z 


z 


z 


r 


D 


o 






< 


< 


CD 


1- CD 




•< 


UJ 


CL 


a. 


CL 


a. 




D 


UJ 


X 




O 






M 


03 3 


o 




> 






v. 


\ 


05 


Ul 


z 


D 


a 






i- 


u 


m u. 


z 


a 


_J 


or 


s 


_l 


-J 




z 


a. 


UJ 




u. 


X 


X 




u. u. 


=> 


Ul 


< 


t- 


Z 


O 


o 


to 


EL 




z 


u. 




Ul 


UJ 


X 


Ui 


-J 


X 


CD 


CO 


o 


Ul 


Ul 


O 




Ul 


a. 




z 






K 


o ^ 






1 




> 


> 




►» 


o 




z 


< 












u. 


O 


JC 


1- 


-J 


-1 




MM 


z 


e 


< 


x 


Q 


Q 




3 W 


h 


o 


or 


tr 


< 


< 


< 


s 


x 


UJ 


M 


r 




Z 


Z 




Ul 




CD 


03 


< 


—J 






(J 


o 


CD 


-J 




_i 


o 


o 


< 


< -1 


CD 




m 


M 


cs 


CS 


O 


> 


CD 






D 


CJ 


cj 


X 


X QL 


CO 


CO 


u. 






a 


tr 


x 




Ul 


Q 


■J 


a. 






Ul 


Ul 


UJ 


UJ 




-I 


z 


Ul 


Ul 


D 


o 


^ 




a 




0. 


0. 


> 


> i- 


u 


cj 


o 


0- 




-J 


-i 


UJ 


o 


_l 






a: 


CD 


CD 


0. 


0. U 


CD 


to 


M 


< 


> 




-J 


z 


o 






CJ 


X 


Ul 


UJ 


X 


X < 


03 


03 


o 


r 




< 


< 


a, 


u. 


o 


CD 


< 


cj 


IX 


tr 


UJ 


ui m 


< 


< 







cj 




Ul 


o 


CD 


o 




z 




Ul 














rft 

UJ 


i ■ i 

UJ 


f— 1 


Ul 




7 Iff 


4m 


CO 


*1 u 








u. 




o 


CO 


-1 


CD 


Ul 


ui z o. 


Ul 


□ 


Ul Ul 












-J 


o 


(J 


O 


CL 


o. ui o 






o. to 


z 










cj 


_j 


1 


-1 


o 


O 0. 1 


& Ui 




o o 


Ul 






CD 


Ul 


i 


u 


CO 


cj 


1 


1 o to 


1 0. 


1 


1 -1 


a. 




UJ 


z 




to 


1 


03 


1 


CO 


CO I 03 


CD O 


X 


X u 


o 




CD 




5 


03 


CO 




00 


03 


OB 10 « 


03 1 


< 


< 1 


i 




0. 




-1 




03 


or 


M 


t-4 


— m or 


- CO 


or 


or x 


X 




< 


X 




or 






or 


or 


or — 




O 


ss 


< 




-1 




< 




or 


Z 






or z 


org 


X 








-J 




u. 


Ul 




Ul 


Ul 


or 


Ui Ul 


Ul 






§ 




o 


0. 




> 


X 


> 


or 


D 


> x > 


or to 


o 


U 


X 




u 




> 






UJ 


o 


□ 


« tm m 


O B 


1- X 




t- 






X 


or 


u. 


CD 


CD 


X 


u. 


u. ID CO 


X « 


CO z> 


D O 


o 


cc 


> 




o 








v. 






^ or 






X 




or 


< 




Ul 


Ul 


Ul 


1- 


Ul 


hi Ul Ui 


h- 


JJJJj, 




Ul 


CD 


< 


or 


< 


or 


or 




X 


or 


or or or 


X H 


U 0. 




X 




Z 


K 


or 


D 


D 


5 


cs 


D 


DSD 


O _J 
















t- 


i- 






t- 


KHI- 


M *5 


_J X 


5$ 


§ 


03 




1- 


0. 


u 


cj 


cj 


U) 


cj 


UUU 


Ul X 










Cfl 


to 


< 


< 


< 




< 


< < < 




< < 


< < 


< 


E 




o 


Ul 


or 


or 


or 


X 


or 


or or or 


X X 


-i or 


cr or 


or 




0. 


0. 


or 


u. 


u. 


u. 


u. 


u. 


u. u. u. 


u. u. 


u. t- 


i- i- 


i- 


< 



«o n cd o* o»<iBO»"irfrOi>»<0'<non»<oooO'»» , » , »''"»"*o«'No 
r>inininiof^NN0Dffl0Bnoo«nn<03O*NNNNKNNNiN.i>.t^oooO'-" 

(MMMhOOOOOOOO"»'«»""<'<''l>00000000000'l)0'0<II 

vvvTru^innininriH^ininrsrjinnB^inrjrvcDCCODtEODCDffl 







o 












cs 












CD 












<t 






CO 


X 






to 


to 








1 CD 




z 


X 


< 










o 


CD 








O 




< 






< 




CJ 


CO 


M 


cs 






Ul (J 














D 


D 


tr 








5 


Ul 


O 






o 


z 


u 






< 




Z 


Ul 


o 


O 


z> 




CD 


10 Ui 


h- 






C5 






-J 


Z 


D 


u 






-i 


z 


z 






Ul 




or 


Z 


< 




Z 


o 


z 


z 




o 






o z 


M 
















Ui 


z 


u 




\ 








< 


z 


X 


< 


O 




z 


o 


X 






_J 


CJ 


X 


to 


CJ 


X 








1 X 


X 


o 


1- 


-1 








CD 


CO 


CD 




or 




CD 


u 


X 


z 


o 


X 


D 


< 


< 


CJ 




< 


o 


> to 


CJ 


o 




-I 


1 Ul 


< 


Ul 


CD 


CL 


tx 


(J 


< 


Z> 


> 


> 


o 


D 


CL 


< 


z 


D 


o 

X 


X 




Ul 




»— i 


Z 


CL 


or 


_J 


X - 


Z 




cs 




1 1- 


tr 


z 


< 




CO 


< 


Ul 


X 


CD 


CD 


z 


Ul 


to 






Ul 


D 


Ul 


z 


z 


z 




o 


X 


-J 


a 


o 








I to 


o 






o 


Ul 


cc 


X 


u 






D 


-1 


Ul 


CL 


\ 


z 


z> 


Ul 


z 


CL 


o 


o 




o 


1- 


M 


to 


or 


_i 




to 


1 > 


X 


o 


a 


a 


tr 


o 


u 


NO 


0. 


0. 


_J 


0. 


or 


o 


X 


CL 




z 


CL 




X 


5 


CS 


X 


z 


CS 


> i- 


03 




_J 


or 


1 to 


1- 




Ul 






X 


< 


to 


CO 








Ul 


0) 




a 


CL 




-1 


D 


LU 


3 


<t 


or 


0) CJ 








Ul 






_J 


X 




o 


»- 


or 


or 


Ul 


Ul 


o 


o 


O 


z 




Ul 


CL 




_J 


< 


Ul 


Ul 


X 






Ul 


Ui 


or cs 


to 






1 (X 


_l 


< 




o 


Ul 


< 




m 


or 


or 


Ul 


ui 


Ul 






< 




Ul 


< 




z 


z 


o 


z 


z 


CL 


X u 




or 


to 


or 


1 to 


a. 


X 


o 






or 










z 


z 


z 


> 


o 


M 


_) 


< 




CJ 


CL 


CL 








CD 


1- z 


5§ 


Ul 


or 


o 


1 Ul 


o 




Ul 


—1 




t- 


D 


D 


z> 


D 








or 


m 


Z 


< 




(J 


o 






> 






< 


o - 


_j 


to *« 


Ui 


3 


i or 


Ul 


> 


z 


< 


cs 


z 




1- 


1- 




> 


> 


> 


□ 


X 


O 


z 


z 


o 


u 


_J 


_l 


CJ 


« 


< 








M CJ 


CO 3C 






z 


or 




X 






• 








< 


< 


< 


i- 


UJ 


X 


o 


Ul 


u 


o 


< 


< 






IM 


z 


z z 


^> 


to z 


m or 


X 


i □ 




< 


J 




_J 




ID 


CO 


co 


cn 


X 


X 


I 


< 




z> 


X 


D 


o 


_l 






3 


Z 


z 






or co 


D < 


CD O 


O 


1 Ul 


z 


D 


<t 


Q 


< 


< 










Ul 


Ul 


Ul 


or 


z 


Ul 


o 


_J 


t- 


> 


cr 


or 




o 


o 






D or 


to u. 


O 3 


o 


1 z 


CJ 


z 


X 


z 


X 


X 


Z 


z 


z 


z 


03 


m 


CO 




o 


z 


Q 


u 


CL 


X 


Ul 


Ul 


UM 


X 


X 


X 


X X 


CL ui 


CD 1 


or 


tr 






o 




o 




o 


I— | 






< 








CL 


X 


CL 


z> 


z 


Ul 


CL 


K- 


t- 


D 




D 


D D 


O X 


4 O 


Ul K 


i 


i _) 


_J 


o 


<_> 


u 


o 


0. 










o 


o 


o 


to 


-I 




Ul 




tr 


< 


CJ 


u 


Ul 


Ul 


Ul 


UJ 


Ul Ul 


cj or 


cs or 


m —J 


tn 


i < 


< 


Ul 


Ul 


Ul 


Ul 




< 


< 


•C 




z 


z 


z 


Ui 


5 




to 








< 


< 


z 


z 


z 


z 


z z 




< -« 


r> < 


3 


1 X 


X 


tn 


to 


m 


tn 


-I 


u 




o 




3 


z> 


D 


cc 


CL 


si 


CL 


I 


CD 


to 


ffi 


tn 


CL 


CL 


0. 


CL 


CL 0. 


X u. 


03 03 


CO X 


X 



t> 


1-4 


o 




m 


n 


nj 




ru 


CO 


t> 


r- 


CO 


t> 






o 


i— 


ra 


n 


*r 


CD 


t> 




n 


in 


-0 


IN- CO 




o 


— (M 


n •» 




m 


in 










•* 










in 


m 


in 


t> 




(M 


fM 


m 


(M 


nj 


(M 


(M 


«r 


«»• 


«r 




•» t 




tn 


m m 


in in 


tn 


-0 


t> 


t> 


t> 


o 


o 


i-i 


n 


n 


n 


n 


n 


n 


n 


n 




CO 


CD 


CD 


CO 


on 


CO 


CO 


CO 


CO 


CD 


CD 


CD CD 


t> 


0- 


c t> 


t> t> 


0* 














ro 


oj 


(M 




m 


m 


(M 


(M 






*r 


1 


f 


«J- 


«r 






T 




<r 


«T 




«r 


V 






T 



V 

u 

*» 
3 
O 



Ch 

I 



< 



t- 
o 

*> « 

• — 

u c 

••» o 

a. C 

* 3 

• • 
oc c 

4* 

3 II 

O «. 

* • 

*» > 

m 

3 01 



Z 
+ 

o 

(J 

Q 



n 



o 

K 
Q 



(- 



C I 
O I 
— I 

I 
I 
I 



C I 
UJ I 

I 



I 
I 

• I 

■o I 

O I 

(J I 
I 
I 
I 
I 
I 
I 
I 



c 

O I 

>*» i 
a I 

i 

u I 

u I 

• • 

• I 

Q I 
I 

£ I 
» I 

-« I 
— I 





-J 




z 


o 


1- 










z 


co 


a 


i 






D 


> 


z UJ 


u 




o 


-1 


CO 


UJ CD 


UJ 


z 


1 






S3 


z 


UJ 


u 


< 


oc 




D. 


UJ 


UJ 




1 u 




O 


z 


X 


a 


> 1 


Z 


1 




u 


CO 


oc > 


M 


> 


"> 


< 


UJ 


55 




K 


z 


oc 


oc 




U 






t- 


1 


z -> 




= 




^ r 


Z o 


- z 


u 


z 


u 


x w 


CO « 




< 




< 


z - 


-J 


r " 










-i a. 


O CO 




CO 




old 


o z 


< o 


s 


D 




< 03 


as O 






X 


f- 


_J z 


Z u 


15 


< 


u 


< 


UJ 


UJ 


0. Z 


QC 


z 


K 


z 


o 


4 O 




D 


1= 


EC OC 


h" OC 


m cr 


z 


& 


Z 


3 - 


< 3 


a a 




SB 


M 


ffi < 


U, CO 



I 
I 

! -s 
i 
i 
i 
i 
i 
i 
i 
i 
i 



1-1 


0- 




fi- 








0J 


n 


eri 


- O 


~ m 


CM N 




a 


r* 


N CD 


CD N 


<0 «0 


O 


o 


o 


* ID 


r> o- 


CD CD 


OD 


CD 


09 


o- o- 


0- o* 



C I 

UJ I 

I 

"O I 

• I 

*» I 

m i 

~« I 

> l 

• i 



< I 
I 

< i 

* ! 

U I 

I 
I 
I 
I 

• I 

■o I 
O I 
U I 




O — CM O — N 

OO^^v^v^CVJ 
4 4 4 4 4 4 4<l 4 
CDCDCOCDCDCDCDCDCD 



338 



c 
Id 



CO 

□ 
z 

> 
-I 
4 

z r 
o 3 

Z H 

4 4 
> 
> < 
c o 
O x 
K Ul 

< 

tr to 
« 3 
0. H 

cn o 

Ui Ul 

ct a. 



u 

Ul 

z in 
o 
_J z 
< 

r r 
o tr 
z z o z 

3 4 z o 
t_ m — 

4 X 4 H 
ZD < 
« Z > -J 

tr e cc — 
< ui o i- 

OI-KZ 
0) < Ul 

tn a. > 
3 * — ee 

t- 0. Ul 
UBIOL 
Ul *- Ul > 
0. EE K X 



Ul 

z 

z 

tr 
o 
z 

CD 
4 

> 

tr 
4 O 
Ul H 
Z < 

a. tr 
o — 
X a. 
»- cn 
tr ui 
o tr 



to 
a 
z 
3 
o 

r ro 
3 »- 

tr in 

a^x" 

ID (D U 
03 _) _J 

tr > < < 
o h r r 
q x a. tr tr 

m c> O D O 
K o Ul m 03 

in u X 4 < 




fs.r>>.r^r*rvr«-r , >.r^Kr > <.r>r».fs.Nf>» 











o - 










© 




o- 












m 




tn 


o o 


© 


(M 




(*) 








o 




CD 0- 


f*. 


n 


<s 




m 








0- 


03 


CO 


03 03 


CO 








OB 


o- 


0- 


0- 


0- 


o o 


O 


O 


n 


«r 


«r 




«}■ 


n 


n 


n n 


m 




N 




r- 


00 00 


CD 


CD 


CD 


03 


03 


00 CO 


CD 


0* 


&■ 


t> Cf 


0* 





o 




X X 


X 


X 






00 






cn 




o 
















3 <J> 




t- 1- 


1- 


1- 


t- 

X 


i- 


i- 


X 




p-» 




Ul 


u 




O 


in 




u 




in tr ui 


o 


cn cn tn 


cn 


cn 


4 




4 


u 


cn 




z 


Ul 




Ul 


o 




Ul 




«- H- Z 


ID Ul 


o < < 


< 


< 


1- 


r 


tr 


tr 


Ul 


o 






z 


z 


z 


z 




z 




Q CO 


« z 


z 






cn 


X 


o 


o 


z 


DS 


u 


CD 




o 












ao uiuinr 




K 0J 




cn 


4 


i- 




x 




m 


•1 


OH 


Ul 


4 


Ul 


Ul 




> 




or o ui o cn 


m tn 


tn 4 3 


< 


3 




cn 


cn 




X 




_i 


Q 


cn 


K 


in 


tn 




_l 


CO 


— *- z z - 


X ~ 


•-> »- h- 


1- 


1- 


cn 


4 


z> 


o 


4 


u 


Cl 




4 


X 


4 


4 




4 




0. o to « z 




t- cn < 


cn 


4 


3 




u 


z 


tr 




z 


cn 


Ul 


a. 


Ul 


Ul 


Ul Ul 


Z 




in z « _i 4 4 4 


z - 






I- 


K 


tn 


u 


r> 


O 


z 


o 


3 


ID 


4 


cn 


CO 


cn z 


o 


1- 


Ul h- o — o 


CO O X 


x o in 


o 


cn 


4 


D 


tn ui 


Ul 


I 


_l 


o 


X 








m* 


4 Z 


z 


U 


ttin--zzK 


OKU 


O 






K 


\~ 




z 




3 




u 


id a 


a 


o 


a 


Ul 


4 


Ul 


« X x o o o 


Z co Z 


Z 3 3 




3 


in 


4 


tn o 




O 


CL 


> 


z 










ID > 




a. 




o 


O 










4 v 




5 




z 


o 


K E 


u 


z 


z 


« _l 


> 


cn 


-< ~ ~ Z Z 3 3 .. 


in tr tr 


CC 4 4 


< 


4 


o 


cn 


K 3 


in 


z 


o 


or 


— 3 


o 


Ul 


Ul 


O 4 


tr 


3 


OTZUIOOUIUI4 


M I 00 


on 


Z 


Z 


\ 




u 


z 


Ul 


4 


1- 


CD 


Z Z 






1- 


Z 


o 


0) 


ouixtrtrzz — 




X X 


I 


I 


3 


3 


Ul > 


Ul 


z 


_l 


m 


■s. 


« i— 1 


cn 


cn 


tn 


cn o 




i 


QOUOOLLZ 








1- 






- tn 




a. 


U 


o 


4 




tr 


> 


> 


- z 


4 


> 


<- O 4 O 


X Ul « 


►i cn cn 


cn 


cn 


4 


4 


x « 






z 


Ul 


Ul 


m cn 


Ul 


cn 


CD 


Ul 4 


tr 


ct 


□ xtruiui_i_ir 


ujz 


z < < 


< 


< 


r 


Z 


<J cc 




h- 




X 


I 


4 4 


a 






N 




LU 




ZtO 


a 






i 


I 


Z D 


Z 


Z 


1- 


o 






o 




CL 


»- CJ 


CL 


CD 


a > 3 3 cr ee ui 


OICC 


Ct K t- 


i- 




t- 


1- 


O Ul 


O 


CI 


cn 


4 


4 


o a 


cn 


tn 


tn 


Ul z 


tn 


cn 


<U)UUU«-Z 


tr - x 


I X X 


z 


z 


tn 


tn 


tr -i 


CL 


Ql 


o 


tr 


tr 


Ul Ul 




LU 


LU 


- 3 


Ul 


O 


cno.<t<<>>tL 


co cn o 


U Ul Ul 






< 


< 


m a. 


tn 


tn 


a. 


f- 


i- 


z z 


Q 


CC 


tr 


K _l 


CL 







o 














o 




o 




o 


























1 - 




CM 






o 


00 0- o 




o 


00 


o 


o 


o 






o 


0- 




o 


o 


CD 




o 




cm n 




CD 


o 




CO 




in 


o »r 


<i 


•coon 


o 








n 


n 


n 


n 


n 


n 






m 


CM 


m 


C> 


o 


t>- 1> 


o 


o- 


0- 


n co 


CO 




n 


o -o 


<i 


v0 CD CD CO 


o 


o 


l> 


o 


o- 


a- 


o 


o 


th 


o- 


o- 














*-< «-* 








n «r 


<J 


> 




n » 






T 




1- 




*r 


<r 




»r 


■d- 




f 


in 


in 


tn 


in 


in 


in 


in m 


r> 


in 


m 


n. N 





339 



u 



O 

«o o 

I 

<0 0. 

o 

< 



(- — 

o c 

*> o 

• E 

— • 

a. c 

•> a. 
• 

CE . 

O 

■*» r- 

3 H 

O A 



3 < 



s- 

EL 



en 
< 

tn 
o 

0. 

> 
z 

K 

CD 
UJ 
O 

z 
o 
u 

x 

a. 



in 











0) 


UJ 








ZZZJI- 












o 


tn 


Q 






uj uj uj a. tn 






CJ> 






r -j 


o 


UJ 




z 


a. a. a. £ u 


x2^ 




Z 




0) 


o u 


-i 


tn z 


z 


UJ 


O O O O X 


t- tn « 


tn 


3 






< 1 


o 


O UJ 


UJ 


a. 


1 1 1 CJ u 




o 


-i 




tn 


ce tn 


1 


-1 0. 


a. 


O 


inn i 


_J CE O 


z 






< 


Z 00 


in 


U O 


o 


i 


03 3 3 < CC 


O UJ CE 




u 






0. 


CD 


1 1 


i 


tn 


-ZZUD 


ce a u 


< u 


tort 


o 


tn o 


< DC 




tn tn 


00 


CD 


CC CC CC X ~S 


(J M M 


x w 


© »- 


z 


O UJ 


M 


cc 


ss 


M 




UI UJ U Z 


- in x 


w z 


z tn 




z - 


UJ 




cc 


CE 


UJ 1- K < «- 


r o 


o 


=5 > 


—J 


z 


UJ 


cc 


tn jb 






uj tn tn ce 


x ce 


UJ UJ 


-1 U 




> u 


u ce 


3 




O 


CE H H 


CC UJ < 

^e 1 


01 






_J z 


o z 


o 


00 — 




3 


X u. z z 


o < 


Q -1 


O 


< o 




U. 


«-« a 


o 




k 5 o o - 


Z UJ 


— < 




r e 


01 




a 






UJ UJ K § U 


O £ 111 


5 01 


O K 


tn 


O OB 


UJ < UJ 


UJ 


UJ 


UJ 


Ul 


UJ J > 


_J — 


I- 




z 


h m cc 


ce 


t- cc 


cc 


CE 


CE CE < O U. 


> 3 _l 


o 


< z 


tn 


< z 


_J x 3 


3 


-I? 


3 


3 


D O u 3 Ul 


JL< 


UJ 


x lu 


UJ 


UJ 


< > t- 


t- 






K 


K 1- O 


< 


t- O 


5 o 


z 


O C5 


x x u 


o 


X U 






UU JZU 


o r 


3 Z 


UJ z 


UJ 


z z 


O 0. < 


< 


< 


< 


< 


4 < tO Ul K 


U 3 


X □ 


O 


3 o 


z cn x 




X CE 


cc 


CC 


CC CE — 0. < 




< -I 


CC V 


< 




< < u. 


u. 


IL U. 


u. 


u. 


U. U O O _l 


Q. — CL 










O - 




D 


T 


0- 


o 






W CD 


CD V 


m 


o o 


o o 


o 


o 


o 








CD CD 


» cd 


CO 


CD CD 


O 0- 








1^ 




fx. 




— 


«r 




ID tf 


o 


o 


o 


o 


o 


o 


n n 


N N 








CD 


CD 


CD 


to 


CD 


CD 



O 

z X < 

JZ3U 
- UJ Z 
Ot- J 

uj tn a. o, 
z < tn 

»Olil 

o a uj cc 

«. UJ z _ 
_J X o 

< O UJ 

x o ~ z 

UJ —J 

> 2 ■€ © 

CE X « 

< _J -J 

o < a < 

Z X Z X 

o o 

uuuu 
ui UJ UJ UJ 

tn tn tn tn 



o 
z 

3 < 
-J CC 

v D 

tn ui 

< r> _) 
ui x a. 
x o 

u z x 

< o tn 

CC CE < 

h a J 

CL 

o o o 

UJ UJ UJ 

z z z 

z z z 

coo 



OUlO 
X UJ O 3 
3 Z Z CE 
Z t- 

to tn to 

K > > 00 

tn tn to o 
< 

— CL CL 3 

o tn tn 

UJ Ui ui CO 
X CE CC M 

o o o *- 

UJ UJ U UJ 
Z Z Z X 

u 

z z z < 

oooc 



z z z z z z 

UJ UI UJ UJ UJ UI o 
00 00 00 CD 00 00 *x 



§1 

UJ z 

< Z CL 

— CL 

Z —I 
O — I < 

x < cc 

3 E *- 
UI - > 

z > 

CL <■ 

_J > z 

< (j UJ 
CC Z 3 

- > _J 
> to u. 
o z 

Z CL « 

UJ 01 CE 

a ui < 

< CE CL 



tn to 

< o o 
« z z 
z 

OCX 
X CE 01 
3 O - 

u z 
z < < 
0. — o 

Z CE 
JOO 

< X 
O 3 - 
U UJ < 

o z - 

U CL Z 

o o o 

X u X 
3 Z 3 

uj o uj 

Z CE z 
CL 00 Q. 



m CD 

z - 

O t- 
X - 
3 X 
UJ U 00 
Z Z UJ 
CL O — J 
CE 00 
Z CD 

k tn 

« CE 3 
3 Z O 

< < 

M K X 

Z U UI 

UJ 3 tO 

3 CE > 

_l I- X 

u. tn cl 

Z 03 X 
— O UJ 



u z 

UJ o 
Z u 

o 

K X 
O 3 
3 U) 
EE Z 
V- CL 

to 

U S ' 
UJ □ 01 
Z CE 
> UI 

< < X 

X 3 CC 
UJ CE O 
01 «- 3 

> < 

X _l 
CL cc < 
X X o 
UJ u u 



U Z Z 3 

ui o uj 

Z U > z 

o x a. 

2 r £ 

O 3 < O 
U UJ CL Z 

o z o o 
x o. z cc 

3 O 03 
UJ H X 

Z 01 3 CC 
0. 3 UI O 

O Z CL 

4 Cl < 
CO > 

CE H ^ 

_i o oi r 

« Z 3 3 
10 » O II 



X U 

< < UI 
X -I z 
UJ u 
O Z Q 
LU — Z 

□ 

_l 01 
3 UJ CL 
O. CE tO 
UI 

uo.ee 

< 3 

o 

CE CE < 

o □ 

CL CL 0. 

< < < 

> > > 

s s \ 
XXX 
3 3 3 

u u u 



00 

q tn h 
z o 

° z t; 

Q Z 

CL Z 

in o o 

UI W UI 

CE Z 
CL 

CE 01 01 

X UI 3 

U CE U 

u 

CE CE UJ 

o o 

CL CL — J 

< < < 
> > a 

^ >w 3 

x x uj 

3 3 _l 
U U CL 



tn 
c 
z 

z 
o 

01 
3 

u 

U K 
UI - 

_l c 

< - 
a 

3 U 
UI = 
_l V 
CL 



X 

01 

z 
< 

o 

CE 

□ 

Q 

UI 



o 
u 
c 

CO 
CE 

u 
I 



.- X 



340 



o 

u 



k r 


z 


X X 


X 


t- 




z 








r 


z 


X 




































z 


X 




X Q U 4 




Q Q 


Q 


0) 




at x 


X 




o 


< 


sr. 


x O 


X 




Ul 




Z 
























X 




a 


X 


O Ul x 


i 






Ul 


X 


Z Q x 


O 


CD 


Ul 




z 


o 




CD 


0. 




S£ 


X 




X 






z 










u 




z 




o 


O 0. Ill 




o t- 


O 


V- u 


4 






Ul 


0. 


Ul 


3 


1- 




Ul 




X 




Q 


X 


C3 


CD 






X 




X 




UJ 


X 




o 




K H 0) 




CC _l 


1- 


Ul 


X 


=>o° 


o 




(0 






O -1 


o 


t- 


1 


< 






a 




UJ 


X 


z 


a 


X 


Q 


co 


CL 


UJ 




ce 


(- 


J to z o 


x 


u5 


ID 


XL 


Ul 


I OS 1- 


1- 




z 


o 


X 


oe 5 


1- 






X 




O 




a 


f- 


u <t 


=> 




D 




UJ 


to 




2 


u 


_l 




4 


M U 


M 


»- g 




< U _i 


co 


X 


3 


z 


4 


u u 


CD 


X 


1 


Ul 


X 


ce 


i- 






Ul x 




a 




O 


h- 


z 


o 


< 




D 


oil J 




X 1 


X 


o z 




x 3 








1 


X 


1 






CO 




< 


u 




co 


X 


Cl Ul 


X 


ce 








3 


z 


X 


X 




1 1 > > 


UJ 


1 > 


1 




s 


Ul X u 


X 


O 


(0 


CD 


Ul 


X CD 


X 


O 




o 


X 


M 




M 




CO 


< 


u 


-1 




X 


1 


1 


UJ 


1 


1 




1 


K I— 


1- 




1 


1 1 1 




1 


M 


M 


t 


1 « 


i 


1 

CO 


CD 


z 


Ul 


X 


u 


X 


o 




X 




3 






X. 


X 


1 


X 


X 


< < M « 


> 




M 




CD 


ODO 




CD 


CD 


CD 


CD 


0) CO 


s 


< 


1 


1 


1 


1 


1 


1 


li 


Ul 

1 


X 


O 


I 


o 


< 


< 


X 


< 


< 


J J>> 


1- 


> > 


> 


>s 


3 


2 => 5 


§ 


i 


O 


O 


O 


o o 




o 




1- 




t- 


»- 


»- 




1 1 


1 


1 


1 


1 


ce 


ce 


se 


or 


ce 






< < 


< 


< X 


X 


XXX 


X 




K 


CC 


oe 


oe oe 


oe 


oe 


<J 


u 


(J 


u 


o 


u 


CJ 


4 < 


< 


< 


< 


< 


< 


o 


O 


o 




o 




> 


U (J 


u 


ou : 


o 


o O (J 




u 


00 


00 


00 


00 00 


00 


03 


Ul 


Ul 


Ul 


Ul 


Ul 


Ul 


Ul 








M 






X 


X 


X 


s 


X 




< 








z 


zzz 




z 


H 




M 










M 












z z 


z 


z 


z 


Z 


z 


1- 


l- 


1- 


1- 


h- 




u 


3 3 


3 


3 O 


o 


o o o 


o 


o 


u. 


Ll 


u. 


u. u. 


u. 


u. 


X 


X 


X 


X 


X 


X 


X 


8 o 


o 


o 


o 


o 


o 


o 


o 


o 


o 












or 


0T 


CKC 


or 


ce 


















u 




o 






11 


X 


X 


X 


X 




X 


c 


X 






o o o o 


o 


o © 


O 


O oo 


00 


ID 00 00 


00 


00 


o 


O 


o 


o © 


o 


o 






z 




z 








=> 


-5 


D 


D 


I 


Z) 






§ 






z 




















z 






z 


o 


o 


□ 


o 


o 


o 


o 






Ul 


Ul 


Ul 


Ul 


UJ 


UJ 




UJ 


UJ 




3 


§1 




1* 






fe 














3 


ce 


ce 


ce 


ce 


ce 


ce 


ce 


£2 




z 


2 


z 


z 




z 


$ 


z 


z 


J J J J 


-1 


-1 -1 


-J 




& 








-J 




-1 


u -i 


-1 


-J 


00 


00 


00 




00 


CD 


CD 


a. a. 


0. 


a. 


0. 


Cl 


Cl 




Cl 


Cl 


Cl 


Cl 


00 00 0D 00 


n 


00 00 


00 


00 00 


00 


00 00 00 


00 


oo 


00 


00 


00 


00 00 


00 


CD 


00 


03 


00 


00 


00 


00 


00 


00 03 


oo 


00 


00 


CD 


S3 


03 


CO 


00 


OB 


00 








t- 


1- 1- 




1- »- 1- 




1- 


1- 


1- 


h" 


K (- 




1- 


1- 


i- 


1- 


1— 




1- 


t- 




\- 


»- 


t= 


►» 








t= 


K 




Vino- 


CM 


n * 


n 


4) o 




NO* 




•0 


o 




CM 


n «■ 






O 




CM 


n 




m 


•0 


o - 




n 


«»• 


m 




© 




CM 


n 




— - m cm 


CM 


CM CM 


CM 


cm n 


o 


n o n 


n 


o 






<» 








r> 


n 


r> 




ID 




Ift 






<i 


•0 
















*4 H H H 












^4 




** 






























«^ 










in 










o o o o 


oooooooooooooooooooooooooooooooooooooo 



c 

Ul 



< 

X 
CL 
O 



CO 

D > 

I— I- 

CO CO 

o 

< u 
_l < 
a ce 
CD i- 

z 

< o 

ce k 
i- 

z 

CS Ul 
Z I- 

_i < 



4 

m CO 
Z CO 

go 1 

_ CD 
00 
< 



X 
u < 

Ul X 

Cl Ul 

CO 

Z O 
3 Z 
I I 

O CD x x 
Ul CO Ul Ul 
Z < -J -I 

a. a. a. 

o 
< z 

-J 3 

-I -J 
Ul 

Z U 

O - 

X CD 

-I Ul 

4 X 

CO < 



Z x 

io 

ce 

X <~> 

X M 

Ul X 

I I 
x x 

Ul Ul 



X I- 

x a co 
a ui 
o H 
I- H 

CO X 



EE 

u u 

CD 00 

I- I- 



0, CL 

X X 

o o 



3 

U X o 
I I I 

XXX 
Ul Ul Ul 

-I -I -I 

CL CL CL 
XXX 

o o o 
u u o 



X 

<J 4 
Ul x 

z 5 

3 Z 

I I 
>- > 

CD CO 



oo oo oo co m 



ce oe 

Ul Ul 

-I -I 

CL 0. 

CO 00 
I— H 



X 

z a 

z o 

3 ce 
o 

X 

4 X 

x i 
Ul (0 
I ~« 
or or 
3 => 
Ul u 

-I -I 

CL Cl 
00 00 



K O 

u 

I X 
> i 

CO CO 
Ul Ul 

—I -I 

Cl Cl 



X 

U 4 
Ul X 
0, Ul 

CO 

z o 

3 Z 
I I 
CJ o 
Ul Ul 

z z 



03 00 



88 

or or 

CL CL 



Z x 

ae Q 
z 

3 O 

or 

X U 

4 »- 
x Z 
Ul I 
I o 
O Ul 
Ul z 
z 

a 

m t- 



I- o 

u -< 
I X 
U I 

ui u 

Z Ul 

z 



I— CO CO 



X 

O 4 

Ul X 

CL Ul 

CD 

Z O 

3 Z 

I I 

CD CD 

□ O 

z z 



X 
X O 

a 
o 

I— H 

-I CD 

3 - 

U X 

I I 

CO 10 

o o 

Z Z 



x Q 
O 

O 

H I- 

_l CO 

3 - 

U X 

I I 

or or 



to 



x x z Z x x x 
OOU4aCQQQ. 

CO O 
UJ UJ 
CL 
CO 
X z 

3 
O I 
I or 
to i- 
o —I 

z « 

u. 

CO CO CO z 

O 

B>y>>>>>ooooooo 
CLorororororororzzzzzzz 

4444444333333D 
XXXXXXXXXXXXXXXXXXXXXXXXXXX-J-I-I-J-J-J-I 



z 

ac x 

z o 

3 

o 

x or 

4 <J 

X i— 

Ul X 

I I 

CD CD 

O O 

z z 



Z X 

X ac Q 

< z 

x Z> O 

ui or 

x u 

x <-« 
Z UJ X 

1 I I 
or or ce 

i— »- 
t t i 



X >- 



I- h- CO CD OO CD 



O 

or or 
o. a. 



O 
o o 
or or 

CL CL 



u u u 
zzz 



-J —I -J 

u u u. 
zzz 



arorceorceororcececececececececeor 

CLCLCLCLCLCLCLCLCLCLCLCLCLQ.O.Q.CL 



cm o-mr)*n<iOHNo»nO'<w( , )*«<oO'<Nn*n>oo<-Nn* 

<0ON«OOOOOOp'<'<HMMM(DISOO(DD)O0'ir'IMMM>^OOOOO 
NnrKIOOOOOOOOOOOOOOOOOOOOOOOOOOOi — — « — 

>>oooooooooooooooooooooooooooooooooooooooo 









X 




X 


z 


a 




< 






UJ 


X 


z 


o 


a 


UJ 


3 


IT 


cn 






<_> 


z 


O 


r 




3 


z 


< 


r 


l 


1 


X 


i 


or 


or 


UJ 




< 


< 


1 


< 


—i 


_l 


—J 


_J 


3 


3 




3 


Q 


Q 


a 


Q 


O 


O 


o 


□ 


z 


Z 


z 


Z 


o 


CS 


o 


e> 


z 


Z 


z 


z 


3 


3 


3 


3 


_) 


_l 


_l 


J 


m 


CO 


m 


m 




h- 


1- 




o 




ra 


n 











341 



z 

> 

o o 
o z 



w 

—I u. 

0. O 

o co 

Z _l 
UJ «-■ 
Q X 

m a. 
a, > 
Ui co 



s 


< < 




as 


o 


z <~< <-> 




o 




J=^l ~ =57 

u z z 


O CO 


a 


> 


2 O O 

2 2 2 


Z 


N. 


r 


5>- 


a. 


o o 


UJ 2 2 


_t — 


to 


Z Q 


ZUJU 
2 2 2 


z 


UI 






e 


-1 o 


Q. 0. 








CO 


Z D 






a. a co co 


< U j CO 


SB 




< o M M 


t- 


u 


w a to co 


o a. co 




CO (J 


o 4 


o 


(- 


M O 


e r r « 


O < K 


u 


CD U 


CO CO CD £ 


u r co 


ut 


< 


<<<<-« 


5 co > 


u, 


« > 


-J _l _l z 


u < o 


u. 


a ae 


a. a, a. o 


O JO 


UI 


•~ < 


oooo 


ZLI 




O £ 


t- K »- < 


« o 5 


UJ 


Z - 


CO CO CO cc 


I X UJ 


h- 


< cr 


*-< S-4 M ^ 


U O Z 


<€ 


u a. 


1 1 1 a. 


ui t- a. 


J 



X CD £ 

Q U) U < 

K Ui x 

a. uj 
k I to 

to i- z o 

m o D Z 

1 I I I 

I X o u 

x < UJ UJ 
<KZZ 

te tr 

?? «« 



z 

a: x 
z a 
z> 

o 

£ K 

< (J 

X <-> 

UJ £ 

I I 

U (J 

UJ UJ 

z z 



u 

x (- UJ 
x Q CO 0. 
Q UJ CO 

O K Z 
HI- D 

Jinx i 
5 « k to 

I o o 

1 I I z 
uuu 

UJ UJ UJ B0 
ZZZh 



£ 

< z 

x sc x x K 
U Z Q x Q to 

© a ui 

O O t- 
Z £ CC t- I- 

1 < U _l tO I 

(I) X H 5 M h 

O UJ £ O I O 
Z I I I I I 
CD CO (D CO 10 
OOOQOO 

H- z z z z z 



r> *> « 



rrKKhhi-Hi-dKhhi-hi- 

© © « < < < 

uuzzzzzzzzzzzzzz 
HH>o,CL(L(Lo»a.Q.a.a.oLa.(LOvGL 



to 

© 

< I 

UJ t_> 

z z 

U O 

< te 
cc m 
»- 

o5 

UJ « 
Z £ 

t- o 

Z UJ 

< z 
z 

cs o 



o 

O Z O O 
Z © Z UJ 
© _l 3 Z 
-J -J 

UJ o 
UJ 00 UI z 
CO O CO © 
O JO J 

-J J\ 
UI z 
oe _j cc u 
ui a ui z 
o. o 3 o 

n m O CC 

5 £ -J co 

oooo 

UI UJ UI UI 

z z z z 



CO < 
O cc 
z © 

UI 

_l 

z a. 

© 

—J -I 

1 t- 

(j QJ 

z « 

O ac 

cc < 

cd a. 

o o 
ui ui 
z z 



cc u to 

© UI O 
UI Z Z 
_l 

a. < < 
cc cc 

J33 
< UI UI 

ae -i -I 
uj a. a. 
o 

to _j _i 

M o. 0. 

© O O 

UI Ui 

o z z 

UI 

zoo 



£ 

£ 2 o to 
© z ui o 
z « z z 
I- 

»- CD £ £ 

(15 O 3 

< « z z 

M Q M W 

Q UI H »- 
UI £ 10 CD 
£ < < 

M M 

h co a a 
z o ui UJ 

< 0, £ £ 

OOOO 
UI UI UJ UJ 

z z z z 



J— ^J-J_I_I_I_I_J_J_I_J_J_J_I 
<<<<<<<<<<<<<<< 
£££££££££££££££ 



oo-- --SSSSSSSSSSSSSSSS*- - ^- ^*^ 





X 1 
















2 












2 




X X 




2 
















yj 


UJ 












£0 
















m I 








X 




UJ 




2 






X 


1= 


u 


< 


2 


a a 


o 


ES 
















3 


© 


















CO 






















6= 


2 


2 


2 


X 


a 






X 


2 






2 


























<€ 




CO 














It 


■Ml j 




z 








■35 


€ 


3 








UJ 


EL 


UJ 


1 


o t- 


o 


2 






2 










2 


< 












CO 






to 


CO 


3 




3 


e» I 




jt: x 




© 


!= 


1 






O 




o 


t= 


3 




2 


K d 


2 








2 


X 




X 


1- 


_l 




2 






a 


CO 


© 






o 






< 


C 


C 1 


£ 


Z Q 


X 


C 


05 


3 


UI 


2 


2 


1- 


t= 




2 


a 




o 5 


2 


Z 




2 


2 


G 




a 


EO 


a 


a. 


O 






UJ 










u 


i- 


2 






UI 1 


o < 




a 




UJ 


1 




< 


U 


_l 


0? 


2 


3 


3 


£ 


M o 




(= 


«J 


2 


3 




2 




UJ 






2 






i= 


CO 


ET 




CO 


> 




O 


2 


4» 




UI x 


o 




e 


(= 


CO 


o 


X 








2 


1 


1 


3 


£ 1 


S 


o 


UI 






O 




o 


!- 


o 


2 




z 


X 


o 


CO 


UJ 


UJ 


o 


2 


z 


r 


* 


C 


« 1 


0. UI 


£ oe 


i- 






UJ 


2 


UJ 


3 


U 


2 


3 


■a 


a 


s« 


1 ES 


1 


1 


a. 


UJ 


E 


a 


1- 






(=i 


O 


UI 


U) 


< 


< 


© 


EL 


z 


z 


O 


o 


© 




O 


• 1 


to 


< u 


=j 


® 


s 


s 


1 


1 


1 


1 


1 


1 


h- 


t- 


W) 


00 K 


a 


a 


m 




< 


o 


3 


CO 


E 


2 


E 


35 


a 


oe 


a 




< 






2 


E 


a 


© 


u 


4» 1 




X — 


3' 




; = 


a 


faj 


UJ 


2 


hi 


UJ 


2 






1 




t= 


»- 


3 


Q 


X 




© 






3 


D 


3' 


3 


i 


O 


oc 


oe 


I 


2 




© 


3 


UJ 




i m • 


'58 


UI £ 


U 


E 


o 


2 


:i 


G 


s: 


3 


2 


3 


-1 


_J 


a 


_l 






D 


2 


Ui 


2 


u 


X 


O 


3 


UJ 


3 






u 


UJ 


< 








UJ 


a 


z 




■»» i 


1 1 


i 1 


1 


! 


1 




o 


c 


3 




3 


3 


3 


2 


,= 


I < 


E 


I 


1 


1 


1 


1 


1 


1 


1 


© 


2 


_J 


© 


Z 


> 


a. 


0. 


© 


© 




z 






» 


i > i 


> > 


> > 


> 


> 


> 


y< 


2 


2 


2 


2 


2 


2 


2 


UI 




U UI 


o 


a 


o 


CJ 


u 


U 


a 


u 


o 


UJ 


a 


a 


2 




£ 






o 


o 


< 


CL 


to 






• i 


to to 


as to 


m 




















2 


E 


E 


< I 


3 


3 


2 


2 


UI 


US 


VI 


UJ 


a 


3 












<s 


< 


u 








a 


CD 


» 


i t- i 












u 


» 






w 


X 


~i 


•J 


u 


u 


oe u 


S 


BE 


2 


2 


s 


2 


2 


2 


2 


a 


> 


o 


> 


> 


> 


_l 


_i 






> 


< 


_j 


M 


O 


1 <*3 1 


e s 


oe oe 


s 


s 




-1 


2 




<€ 


<€ 


<€ 


2 


•3 


2 


3 


»- < 


1= 


5= 


















cc 


t=j 


ce 




oe 


-1 


_J 




© 




_J 


CO 


CO 


C 


1 A 1 


D D 




3 


3 










s 


a 


E 


s 


!£ 


K 


a 


oe 






BO 


■s 


a 


a 


« 


SB 


a 


> 


3 


2 


"Z 


< 


< 


UJ 


UJ 


a 


2 


< 


a 


< 


o 


« 


1 < 1 


UI UI 


UI UI 


It) 


tt; 




o 


3 


o 


O 


3 


J 


1 


;= 


t= 


t- 


K 1- 




»- 


H 


H 


»- 


»- 




t= 


1- 


a 


Q 


: 


3 


2 


2 


(- 


b— 


t=i 




z 


UJ 


UJ 


X 


• 




_) _l 


-1 -1 




2 


=! 


3 


S 


2 


2 


2 


3 










< 


2 


2 
















2 


Z 


2 


3 


O 




UJ 


UI 


EL 


a 


o 




E 


1- 




1 < 1 


0. 0. 


a, el 


a. 


& 


Q. 


h- 


t= 


{= 


t= 


;= 


1= 




<j 




_J 


-1 _l 


-1 


J 


EL 


EL 


EL 


EL 


EL 


EL 


EL 




O 


© 


3 


£ 


E 


Q 




O 


o 






K 




Q 


ill 


























3: 


3 


o 


O O 


3 


3 


to 


to 


CO 


CO 




CO 


CO 




<J 




_l 








oe 


o 


o 


_J 


oe 


CO 


2 






BO CO 


CO 00 




Xs 


S3 






SI 


s 


■a 


a 


S3 


2 


2 


3 


CO 03 


3 


3 


UJ 


UJ 


UI 


UJ 


UJ 


UI 


UJ 


oe 


UJ 


2 


© 


© 


© 


O 


o 


X 


X 


© 


3 


o 


K 


m 


1 U 1 


t- 1- 


1- K 




t= 








1- 


r ^ 


t= 




t= 














OS 


K 


K 


K 


ae 


a 


<z 


a 


CO 


a 


a 


EL 


a 


a 


m 


3 


33 


EL 


© 


a 


O 


a. 

u 




O - 


w n 








© 




(M 


O 




rs 


2 


© 




cm n * r> o 


o 


H 


EM 


n 




ET> 


2 






























c 


1 • 


O O 


o o 


a 


© 


© 
















CM CM CM CM CM EM CM 




2 


03 


a 


3- 




G 




a 


□3 


03 


^> 


© 


© 




a 










o 


•9k 


1 "O 


r M CM 


EM CM 






CM 


CM 


frj 


CM 


fd 




w 


fd 


CM CM CM EM EM EM EM 


EM 


ru 


3 


CM 


3 


CM 


EM 


© 


© 


© 




CM 




a 






n 


0- 


CM 


m 


en 


u 


1 o 




















































2 


CM 


2 


CM 


EM 


n 


n 




n 


n 


n 


in 


m 




EL 


1 u 


oooooooooooooooooooooooooooo 


© 


© 


© 


© 


© 


© 


© 


© 


© 


© 


o 


o 


o 


© 



342 



(J 
u 



I 

— • « 

• c 

o> o 

4 c 

a 
. • 

u c 
o o. 

4* 

m m 

c c- 

— • 

o. > 
« • 

• 0) 
K 

*» 6 

3 N 
O H 

e. A 

4* • 

— at 
3 < 



E 
•t 

O 

o 

Q 
E 



(J 
-0 



o 

or 

Q 



o 

u 



- * 

o 
c 

* 

14 
Q 



u tn 
ui o 
z z 

ut u o 
z z z 
a. a. 

V X CD 

_) _i « 
o o to 

Ui tit o 

iii 

u 

o o o 

CCI 
Ui bl 5 
J Jlil 

ill 



OOt- 

to « UI < 



E 3 

z a. 
a. 

ui 

K O 
►* Z 
£ UI 

5 co 

> CD 
X UI 

a v. 
o -J 
o - 
u. o 



Q 
I- < 

— or 
z 

O I- 

e v 
3 a 
ui 

z u. 
a. « 
z 

O 4 
« £ 

_l 

— a. 

CD < 



I- CJ CD 

< UI O 

•» z z 
a 

4 H •- 4 
0C Z Z _l 

UI 

»- O O K 
^ 4 4 CD 

a m 

t- *- U. 
U. x x 
« UI UI I 
z t- 

< .. .. M 

r a a 3 
z z 

JOO< 

Dour 
a. ui 
a. a. > 
ae to to a. 

Z UI UI £ 
o oe BE UI 



< o 
-I z 
3 

I- CO 
CO 3 O 
M u. Z 
U. U, 3 
UI -I 
O x 

MtlL 

3 3 O 
UI 

4 _l CO 
£ 0. CD 
UI UI 
> t- u 
a u to 
£ < a 
ui as < 



£ co 
Ik 

K J UI 

CO O CD 

< lu a. 

> 4 
a _j _j 

O OS > 
as or 
10 « < 
to u. z 
Ui o 
U O £ 
CO ~ _l 

a] o 5 

4 CL 



U 

u. 

3- 

at ui 

z DC 



£ -> 

^2 

a. 

§1 

4 H- 

0£ 4 
I- 0C 

M 

0. 

CD CO 
O 1:1 

a. or 



UI o 

to UI 
a to 
■J o 

U -I 

I u 

to I 

CO to 

m CO 

or f« 
ae 

ui 

> x 

u. to 



to a 

□ ui z z 

-I CD UI UI 

o o. a. 

1 JOO 

to (J I I 

a i to co 

HOBO 
q; H H H 

a: ae oc 
ui ui or ui 

CO £ U. U. 



Ui UI UI f- UI Ui 

ae ae oe I ae oe 

3 3 3 O 3 3 
Hhl-M(.(- 

uuuuuu 

4 4 4 4 4 
aircxira: 
u. u. u. u. u. u. 



z 

UI z 

Z 0. UI 
111 O L 
0. I 5 

CD I 

1 03 CO 

co — m 
03 ae m 

<- ae 
oe z 

ui ui 
x > oe 
— WO 
CO tO £ 

UI UI H 

oe oe x 

3 3© 
hhN 
CJ U UI 

4 < 

oe ae x 
u, u. u. 



m 

a 
i 

CO 
o 
z 

CO 

03 K 
« CD 

oe Uji 

h" <J 

5^ 
£ •-> 
4 
X _| 
U. U. 



UI 

CO z 

UI 

1 I 

x x 
4 < 
oe ae 
o o 

X X 

»- I- 

ss 

3 3 
UI UI 

z z 
a. a. 

£ £ 

3 3 

4 4 
ae ae 



o 
ui 

CO z 
O UI 
-I 0. 

o 

1 I 

X X 

4 4 

oe oe 
o o 

X X 

I- K 

O □ 

£ £ 

UI UI 

X X 

£ £ 

4 4 

oe oe 



z 

-I 0. 
cj O 

I I 

§g 

X X 
H »- 

o o 

£ £ 

UI UI 
X X 

o o 

Ui UI 

z z 

0. 0. 
£ £ 
4 4 

ae oe 



a a 
ui o ui 
to UI CD 
OHIO 
_l O _l 
UJU 
I U I 

CD I z 

o z o 

ZOh 
<- K 

> CD 4 

oe D oe 

3 H U 
"5 Z U 
Z O 4 
t-> cj _l 

ooo 
z z z 

S D 3 
* 1 I 





n 








lf> 


«0 N 


3D 




r> 


o 




® 


Ef- 




o 


r> 




O 


O O 


O 














n 




03 


CD 


o 


N 


N N 


N 


IN. 








N 




•** 




ii 


»h 




o 


O O 


O 


o 


o 


O 


o 


o 


O 


so 


r» 


t?s 


m 


N 


© 


CD CD 


CD 


05 


m 


CD 


CD 




© 













O 






* o — 




r> 


-t 


m 




CM 




N O O 


o 


o 


o 


o 








O •'O <0 




o 


<i 


«o 








CD CD CD 


CD 


m 


CD 


CD 


CD 


CD 











9 












O 












CO 












4 






CO 


X 






CO 




to 












o 






CD 






£ 


4 








§ 


O 


CO 








i 


1- 


4 






4 


« 


u 


CO 


»— < 


o 






UI 


a 


M 












z 


»- 


UI 


O 








oe 


u 








UI 


O 










u 






4 




Z 


UJ 


o 


a 






to 


to 


UJ 


t- 










o 


3 


t— < 


J z 


Z 




J 


Z 


D 


UI 






-I 


z 


z 






UI 




oe 


Z 


4 


1-4 


z 


o 


z 


z 




o 






o 


z 












z 


_J 


z 










«— i 


UI 


z 


u 




\ 








4 


z 


E 


4 


o 




z 


o 


E 






_i 


o 


X 


CO 


o 




X 










z> 






! o. 


T. 


X 


O 


1- 


-1 








CO 


CO 


CO 




oe 




to 


U. 


E 


z 


o 


E 




4 


4 


o 




4 


o 


> 


to 


CJ 




© 






_l 






to 


UI 


4 


UI 


co 


0. 


0. 


u 


4 




> 


> 


o 


D 


a. 


4 


Z 




o 






UJ 




t— > 


z 


a. 


cc 


_l 


E 


kl 


z 




z 








to 


3 


UI 


1- 


ae 


z 


4 




to 


4 


UI 


X 


CO 


to 


z 


UI 


CO 


_l 




UI 


E 


i 




z 


Z 


z 




o 


X 


-I 




a 


o 




D 




z 




OC 


UI 


oe 


to 


O 






o 


UI 


oe 


X 


o 






D 


-I 


kl 


0. 




z 


3 


UJ 




a. 


O 


o 




o 






CO 




oe 




_J 




3 


to 


CL 


z 


| v. 


> 


X 


o 


a 


UI 


oe 




o 


z 


a. 


0. 


_l 


0. 


oe 


o 


E 


a. 


Ui 


z 


a. 




E 


E 


o 


i 


Z 


O 


> 


i- 


03 








_l 


oc 


a. 


0. 


! x 


CD 


i- 




UI 


z 




s 


4 


o 


to 


to 








UJ 


to 




z 






_i 


3> 




UJ 


3 


4 


CC 


CO 


o 












UJ 






< 






-1 


£ 




O 


1- 


oe 


oe 


UI 


UJ 


o 


o 


o 


z 


i— < 


UI 


0. 




_i 


< 


UJ 


UJ 


E 






u 




UJ 


ae o 




CO 






aC 


oc 






0. 


_i 






o 


u 


4 


i— 


03 


ae 


oe 




UI 


UI 






4 




Ui 


< 


<j 


z 


z 


O 


Z 


Z 


a. 


I 


u. 


X z 




oc 




to 


CC 


K 


z 


° 


CD 


a. 




a 




z 


oe 










Z 


z 


z 


> 


ci 


*— < 


-J 


< 




(j 


a. 


a. 


H 


*-i 




to 


(- 


z 






UJ 




o: 


o 


to 


o 


X 


UI 


o 




UI 


_l 




i— 




D 












oe 


00 


Z 


4 


rsi 


CJ 


o 






> 






4 


o 




_l to 






UJ 


3 


1 


« 


i »- 


oe 




> 


z 


4 


o 


z 




1- 


i— 


1- 


> 


> 




o 


E 


o 


z 


z 


o 


u 


_) 


_J 


<J 


4 


4 








-1 




u 


to 


a£ 




at 


1- 








oe 




E 




« 


< 


»-t 




•i 


4 


4 






UI 




o 


UJ 


a 


o 


4 


4 








Z 


z 


z 




CO z 


t—t 


cc 


E 


or 


< 


! o 


o 




4 


_i 




-I 




CO 


CO 


CO 


CO 


I 


I 


X 


4 






E 




o 


_l 


t— ■ 


*— < 


3 


Z 


Z 




»— • 


»— • 


oe to o < 


tn 


o 


O 


< 


_l 


UI 


UI 


z 


Q 


4 


a 


4 


4 










UI 


UJ 


UJ 


oe 


z 


UI 


o 


_J 


i- 


> 


tc 


tr 




o 


o 








D oc 


to u 


o 


3 


a 


00 


*—* 


j z 


z 


o 


Z 


r 


z 


X 


E 


z 


z 


z 


z 


m 


m 


m 


*— < 


o 


Z 


Q 


u. 


CL 


I 


UJ 


UJ 


E 


E 


r 


E 


r 


E 


Q. UJ 


01 


1 


tr 




r: 




Y- 






1-4 


o 




o 




O 
















a. 


E 


OL 




z 


UJ 


a. 


h- 




D 


D 


D 


D 


D 




□ E 


< 


Q 


UI 


1- 


I 


_J 


z 


' _i 


_l 


-I 


u 


u 




o 


a. 










u 




<_! 


to 


-J 




UJ 




a. 


< 






UJ 


UJ 


UJ 


UJ 


UJ 


UJ 


u ae 






m 


J 




CL 


UI 


< 


< 


4 


UJ 


u 


UJ 


UJ 


i-i 


4 


4 


4 


4 


Z 




z 


UI 


Z> 




to 




1- 




< 


< 


z 


Z 


z 


z 


z 


z 


3 4 


< 






< 




< 


> 


£ 


r 


X 


CD 


to 


to 


CO 


_i 


u 








3 






oc 


0. 


3C 


a 


I 


to 


to 


m 


03 


0. 


Q. 


0- 


CL 


CL 


a. 


E U. 03 03 


to 


r 




r 





CD 


0^ 




o 






n 


m 




OJ 


CD 


Ch 


in. 


CO 


o- 




1-4 


o 




OJ 


n 


«r 


CD 




— i 


n 


lO 


~0 




CD 


i-« 


O 




(M 




f 


in 






r> 


r> 


to 


r- 










▼4 








m 


r> 


to 


t> 


n 


OJ 


n< 


rn 


Ol 


CM 


OJ 


OJ 


«r 


«r 












to 


tn 


IT) 


m 


r> 


in 


in 


m 


-0 






t> 


o- 


0- 


o- 




n 


n 


o 


n 


n 


n 


n 


n 


i-« 


CO 


CD 


CO 


CD 


CD 


CD 


CD 


CD 


CD 


CD 


CD 


CD 


CD 


t> 


0- 


o- 


O 


o 


0- 


t> 




o- 
















OJ 


OJ 




OJ 




OJ 


OJ 


(M 


Ol 


«s- 


•t 




t 


t 


<* 






•* 


«* 


«* 


«t 








1 


f 






*r 


f 







419-177 



343 



84 



23 



cj 



0* 

•c 

I 

— i ID 

■l C 

Ot o 

< E 

3 

. II 

(- C 

o a. 

« « 

i- «- 

— 01 

a. > 

* *> 

• CD 
K 



O 

N 

It 
A 

Oi 

ei 

■C 



2 

O 
(J 
a 
x 



s 
o 









CP 
























— 

c 


J 

— 1 z © 








O 111 Z 




ID 


_J 


• 1 CL D 




> 


< 


' O O — J 




CD 




|W2 1 -v 






CJ 


' Z UJ (J 4 




cr 


z 


1 £L UJ UJ 








1 "5 O Z X 




a. 


LT' 


1 Z 1 O 




in 


C 


>->>->< 




UJ 


cr 


! irze 




cr 


c 


l (J D - K 




i 




1 — ~) >v 




r cj 


L- 


1 cj Z U x 


tf3 


tfl — 




, < — < z 




— _J 


O 


CT CT > 


J 


_i a. 




i o in o cr 


2 


C £ 


X 


! I r> I < 


ea 


ffi o 




i- x i- _j 


2 


r u 


< 


I < u < 


l*i 


UJ 


c 


i cr z cr z 




CJ 


o 


i i- o i- cr 


3 


i- cr 








< D Q 


1 m cd »- m 


5 


u. in 







r> — t> 






o 


i ru P5 o — 


© 


•< n n 


=e 


■ ru m a n 


CD 


cd * 


O 


■0 >0 < * 


in 


in o- — 


cj 


1 CD CD CO 0- 


0- 


t> o-m 



CL 



c 








o 
























Q. 
















(- 








u 








r l 








* 1 








O 








JS 










a 








UJ 




s 


— 


CD 


2 


UJ 


w 


z z o 


tii 


ffi 


C 1 


UJ Z UJ _l 


5= 


Q 


UJ 


CL UJ CL U 


2 


-1 




o o. o i 


1 


U 




1 O 1 > 


> 


1 


tl 1 


co i z tr 




> 


*» 


O Z O D 


2 


s 


a 


Z O - "5 


2 


D 




-HZ 


2 


2 


> 


> in < « 




2 


« 1 


cr d cr 






u 


D i- ui r 


2 




1 


~> z u © 


© 


CO 


A \ 


z o < < 


< 


2 


4 


« U J IT 


3 


2 




X 


2 


CJ 


< 


O © © 0. 


a. 


2 




z z z < 


2 


O 


£ : 


I? D D ~ 




K 


u 


J J JO 


a 


GS 



«5- 
C 



m I 
ti I 
2 I 





o — m 






a 


n n n o 




CM 


•o 


— — — CM 




ru 





<o o -o >0 




« 


CJ 


CD CD CD CD 


© 


2 

t 



I UJ 

i cr 



l_ 



< I 

I 

< I 



a 

a. 

in 
i in 
i cr 

i 
i 



z 
o 



< z 

tr c 

CL H 

cn < 

111 h" 
cr •- 

o 
o in 

10 
UJ UJ 

u tr 

ife 

in 

« in 
en o 

52 

K 

_l UI 

< r 

cj 

— _i 
z < 

< u 
X - 

CJ Z 
UJ < 

r x 

CJ 

cr UJ 
UJ z 
X z 

K O 

o z 



ru n 

Ch o 

n n 

o t> 



344 i 



MDC 04, DISEASES G DISORDERS OF THE RESPIRATORY SYSTEM 



075, MDC 04 P , MAJOR C HE ST PROCEDURES 

076, MDC 04P,O.R. PROC ON TUE KESP SYSTEM EXCEPT MAJOR CHEST »ITH C.C. 

077 , M DC 04 P,0. R. PROC ON THE RESP SYSTEM EXCEPT MAJOR CHEST W/O C.C. 
07 8 , M DC 04M, PULMONARY EMBOLISM 

079 , M DC 04M, RESPI RATORY INFECTIONS t> INFLAMMATIONS ACE > = 70 AND/OR C.C. 

080 , MDC 04M, RESPIRATORY INFECTIONS G INFLAMMATIONS AGE 18-69 W/O C.C. 

081, MDC 04M, RESPIRATORY INFECTIONS G INFLAMMATIONS AGE 0-17 

082, MDC 04M, RESPIRATORY NEOPLASMS 

083, MDC 04M, MAJOR CHEST TRAUMA AGE >=70 AND/ OR C.C. 

084, MDC 04M, MAJOR CHEST TRAUMA AGE <70 W/O C.C. 

085, MDC 04M, PLEURAL EFFUSION AGE >=70 AND/OR C.C. 

086, MDC 04M, PLEURAL EFFUSION AGE <70 W/O C.C. 

087, MDC 04M, PULMONARY EDEMA G RESPIRATORY FAILURE 

088, MDC 04M, CHRONIC OBSTRUCTIVE PULMONARY DISEASE 

089, MDC 04M, SIMPLE PNEUMONIA G PLEURISY AGE >=70 AND/OR C.C. 

090, MDC 04M, SIMPLE PNEUMONIA G PLEURISY AGE 18-69 W/O C.C. 

091, MDC 04M, SIMPLE PNEUMONIA G PLEURISY AGE 0-17 

092, MDC 04M, INTERSTITIAL LUNG DISEASE AGE >=70 AND/OR C.C. 

093, MDC 04M, INTERSTITIAL LUNG DISEASE AGE <70 W/O C.C* 

094, MDC 04M, PNEUMOTHORAX AGE >=70 AND/OR C.C. 

095, MDC 04M, PNEUMOTHORAX AGE <70 W/O C.C. 

096, MDC 04M, BRONCHITIS S ASTHMA AGE >=70 AND/OR C.C. 

097, MDC 04M, BRONCHITIS G ASTHMA AGE 18-69 W/O C.C. 

098, MDC 04 M, BRONCHITIS G ASTHMA AGE 0-17 

099, MDC 04M, RESPIRATORY SIGNS G SYMPTOMS AGE >=70 AND/OR C.C. 

100, MDC 04M, RESPIRATORY SIGNS G SYMPTOMS AGE <70 W/O C.C. 

101, MDC 04M, OTHER RESPIRATORY DIAGNOSES AGE >-70 AND/OR C.C. 

102, MDC 04M, OTHER RESPIRATORY DIAGNOSES AGE <70 



345 



Figure 4A 

Major Diagnostic Category 04: 

Diseases and Disorders of the Respiratory System 

Surgical Partitioning 

OR Procedure 




Procedure Category 



1 




CC= Comorbidity and or Complication 



3SPSSIQ 



Surq |pi}ijsJ3ju| 



At 5 

< S 




Q v. 



a 
a 



Xsun^d pup / 



eiuoainaud d|diuis If 



8SP3SIQ AjPUOUU|n<J 




40 

s 

C 

eo 

<v 

Q 

a- 

u 

c 



Xjo}PJid»y pup 
puuapg /Cipuotuin^ 



uoisn^g ipjnsid 



ptunpji ' 



O 
O 

U 



1/1 

>- 

O 
"SS 

a. 

i/i 
<u 
a: 



o 

wo 

o 



jsslq joIpw 



LUSP|d03N 



suoqpujujp^ui 
pup suoipa^ui 



O 
c 

m .2 
Q 

ii5 



-o 
c 

OJ 

cu 



c 
E 

o 



■o 





09 
< 




aisi|oquJ3 



Ajpuoujin,;) 



a . 

,-» . i* 




u 

5 
■a 

-g 
o 



u 



347 




348 



E 
0) 

4-> 

1/1 
>> 
CO 

>- 
s- 
o 

"So 2 22 *< «-> _ ZX XH- X £ 

s- Cxs\ *x ki-j<j:xoxkjj 2 X*3XOi/>3<Z o<2 

"»T 'XI tZOX3V1iij<2a 3^0. *X Z t-><2 3 LUuJXi^X X^tXIX^X XI- 

« _j^043 j oj-xiuj jj/ii^oxq/j j^x x^xixjj jt-aoj^JO'^a. jjzsxj^ 

£ ux o 3>— -o 3_jo*-2<3 a -xi xzoxa/)iaj ach-t— ■/> 3 3 xc/> 3 3 jj 

en ^II xlXJC*-f- 23Xa£3>- 3X J 3»-_><3 Q -U^> J J»-ZJ 3 3— 

J! X 3Z OX^S^i" I I X-> I y> <O_J^Xi0J3ZaC»— t- 3ZXXUZ3 • I 4UJ^Z I I <J_l^lJJ 

£ E I I 3ZjjruZ3^^iJZ/lZ3^3X-3Ht-^ <Jj^)ZI I J I I I I OJ^a^i-^K-S—i 
i I i I I I I -i- * i I -h i i »ZjjijZOZ3><-«D-'-xxi xx«J4JiJZ JI303jjr JZ0-n 

M_ o /n/>»/>on />./>i/)-/v./>4/)./X i I l I I I 3ZiJZJZJ«>««4ZZI I I • I 22 I I I I I 2 

O C->>DDD3330Qa03JJ3i-f-f->-(-<-h- I | | | i i I 3C 3£ j£ a£ d£ JC a£ J JJJ J uO>/l^ yi-o 3 

rj ~ jjujuvjjoj-naaaaaouiujujijwjj-"^— "£xiiixx'-»-^^ziz»-^zzzz^>' 

SJ to Zi^ZZZZ—'-.-iw-i-.-.-H^MxZZZZZZZ'-NfHf.t-h uO 

■O <U IX3J333J3iU.U.U.ltHlLZIIIZIZa3a33333J3J333>->-a)Iiaaa»-flll2iafl- 

s_ o utocacicocatat jju^uwui.xa.j.ii.i.i.i.i.a.j.ti.xttr-p-'-^i-utiF.t-^f-p-i 

t ZZ ZZZZZZZG333a30iJUJiJLjjJjJiJ'UJJjJajaj^ZZZZZZZZZZZZZZiiJ 

Q -r- 33XU.U.HiU.X33J33J3Xa:aCJtOCJCJ£ZZZZZZZZZZZZZZa3J333JJJJOJJ3-J 

"O CD _J_J J J J_J 



■a.ina.aiiia.a.a.a.ii'- 



10 

■J- O -l~»-«.HJ.-4~4-4-*HH-4-H h)H^HHHHHHHH-.-4-4-.H-«-4-4-«-4-4-4H.- 1-4-4-4 -4~.-HH-4~.-4-.— 1-4-4-. 



to 
c 

xa -m 

(tJ Cl 



i_ 

o 

a! 2X XH- X XXX»- XZXXX>— 2 2X X»- X X^ X2XX 

O X^.aX3^J<Z333^J<^a33u1 *X X»- Z^3X3^ IZ3K3>flJ<^33 

' o<z a xilux^ uj>xix2 x» zzjxj^j<z 3 _u.-><^ o ajjjxz 

-fjl 3>- UJX3 3 3*-O.UJ2 3*-3^- a.!Xi33*-<3*-«J<3 a -UJJX33 JHjjXZJ U^la;3Jf- 

.r- x < a. u >— /> 3xjH -o jh :jx 3 3»-o.'u tc»— :vu3'i£*-*- <» ac-/ 

r- <3 — "-0^> ZJJ^IZJ J3-nXZaiJ3^XlJJ£XHH -O zjji^I^ JJ^IZ3U3 

cr> t— »- Z^Z3X^3-"-3ZI«J«fJZ<-4y-»-^ <JJ/IZZ3<-»3-*-Z3Z^3«»-3Z<«J 

C ^)S3'Ji3Z.lJ>.JXJ I KCIZJI I XI I XOZ'JXM JMr. u£UX J J^4£ JXJ I 1X3.1 
c Oi-ZU I I I I I I I >->-X I >— • 6 UU'JJ toil 3ZXIXOX3 1 I I I I I I I I X • I • I >->- XI I >> 

_cr ©'"xi — *«;»»; >x»«i -vsivr,u«";/?<s»t/ituixi • jjjuj i i i t i i i xjcixjt at rat jcjchj at uljcoc 

■*-> «^ ZX^XIXIXJ XI JJ XI XI jJ.jjhh | «— —"-^-^^^^JJJ^ XI UUU1^»lO vision yir—r-r—»—r—>—r-«i <» I <i<i<i<i—'— <-»-—<— < 

•r; ^ 4 -» JZ-* J -I J-J— I -J-J* J£"* * TCTC a£ Jj ZZJJJJ33 3JJJJJJJJJJJJ-IJ»'->> 

* .IT -I •* JJ X. J^JJJJJSOZ U Z4ZZZZZ-- 'xhh-.hJ33JJJJ44-.4X 

to JZL££ZZCiiUJJ UJJUJ Unr S«— DS XXXXXXX J J J J3aaJ'J> J J 

a; (j ^lHy)4Z33333 30JJJJJJJ >-»-OaflaoiiazZZZZZZJ3'JJ333 < 

"2 ^ Z JJ3JJJJJJ J111111XJJ*- J t - r - > -»-h-h-^--.-.-4H-4-4-«Z2ZZZ ZZ2Z _>-C_e 

° ° XJ^ijj 33 JJJJ 

jc— i aaafl a - oflflaaaoflaa£acxxxx*»->->'>->'>JJJJJJJ-3JJOJJJJJJ JO 

z: _c •— >zj*-f—>-i-f-'— >-f-i-"— f-ao.xia.xa.'xxxxxxiizzzzzzzz^zzzzzzzz^z 

<-> to Za£3n -*<<<<<<33333333333:2— '333333 

' •■- JJoJ£i3ZXZtZEEI C£ZX££XXCX£XZ££LXX£XJJJJJJJJJJJJJJJJJJJ 

^Zt-^l JJJ-.HHHHHH-H-.-H-.-.-.-._.-,-.-.-. — H-._.HH-,-..-. 

c, c Q<xacaCTC x X.-X.-X.X. X.*. x cxx. ^jcjcacacjcac iccacasac jcac-oaafl ax> oaaanaaaaoaaaa 

o u_ j< j^<aaa.ixaQLXCLXxQ.iaixxa.a.iQ.a.aaQ.a.a.iQ.p-'-»->-'-t-i-'-f-^t-i--»-^-'-'--^- 



OONWS-JOO'Jaa O'-*— '"-h —«—«•-« 'H ^jtOcXJ 33a3 0a5»<7>0»a»J»3«(7>OO3OOOOH-4HHHHHr\(\^i\.\ 
*J tt*^^H^«0OOO3OO33O3O0OOO3OOOO03OOO3 33-HiHH-4r-»-4-4H-4H-HH-*-<-H-4-4-HH 

g 3>»03303000000300030033030000 30000303000003000000030 
c 

en 

CO 

to 



349 



Table 7 

Code English Description 

01201 lb PL EUR1 S Y-lxL tXAM 

01202 Tb PLtUK 1 SY-tXAM UNKN 

01203 Id PLEUklSf-MlCKL LA 

01204 Id PLbUKl S Y-V.CLT UX 
0120!? lb PLtUkiSY-hl SICLUG OX 
01200 lb PLbUklSY-UM TtST 

01210 Tb IHlkaCK NLLES-UNaPEC 

01211 Id 1HLKAX NUbE-NU tXAM 

01212 lb IHUkAX NUUt-bXAM UNKN 

01213 lb IHLKA A NLlb-MiCkU OX 

01214 lb THokAX NUut-CLLT OX 
0121b lb IHlRAX NuLb-HIsTu UX 
01216 lb lHLkAA NuUc-UTH TbST 

01220 lbUL TkACHtAL TB-UNSPEC 

01221 ibUL IkACHbAL 1B-NU bX AH 

01222 IbUL TkACH Tb-bXAM UNKN 

01223 IbULAl 1 k ACM Td-M1CKU UX 

01224 IbUL I kACHEaL Ib-CULl DX 
0122b iiULAT TkACH Te-H1ST0 OX 
01226 liULAl TkACH Tb-LTH TbST 
012B0 KbSP Tb NbC-CNSPbC 
0l2bl RbSF lb NEC-NL b X AM 
012b2 KtSF lb NEC-cXAM UNKN 
0l2b3 KtSF Tb NkC-hlCRC UX 

01264 KtSF lb NEC-CCIT UX 

01265 ktSP lb NEC-HlbTL OX 

01266 RESP Tb NEL-LTb TEST 
0*03 PRlMAkY PNECMLM C PLAGUE 
0204 SECuNUARY PNcCMON PLAGUE 
020? PNt LMCN1 C PLaGLE NQS 
0212 PULMONARY TULARtMlA 
0*21 PULMONARY AM b h AX 

0310 PULMONARY MYtCfeAC TbRI A 

0330 bOKOt TbLL A PtRIUSSlS 

0331 bLROt TELL A PAkAPERTUSSl S 

0338 hHUOPING CGCbb NEC 

0339 HhQLPlNG CGUuH NUS 
0391 PuLMUNAk Y ACT 1NGMYC0S1S 
0521 VARICELLA PNcLMOMTIS 
0551 PuSTMtASLbS PNbUMONlA 
0730 LKN1THUS1S PNtLMCNIA 
0741 tblOEMlC PLtCRCUYNlA 
0951 SlPhiLlS UF LLNG 

1124 CANCILiAalS Lb LUNG 

1140 PRIMARY COUIGIUIUOMYCOS 

11505 H1STUPLASM CAPS PNEUMON 

11515 H1S1UPLASM Ucb PNE0M0N1 A 

11595 H1S10PLASHUS1S PNEUMONIA 

1212 b AK AGLN 1M 1 A b 1 S 

1221 tCH INlLUCC GKANUL LUNG 

1304 IUXUPLASMA PfNtLMUNlTIS 

135 SAkCUlOOSIi 

1363 PNEUMLCYSTCSlS 

1370 LATE tbbbCI lb, RESP/NOS 



(Continued) 

Code English Description 

lo20 MAL1GNAM NEO TkACHtA 

1622 MAL1G NbU HA 1 N bkONCHUS 

lo23 MAL NEO UPPtk LUbE LUNG 

1624 MAL NEO M1U0LE LUbE LUNG 

1o2d MAL NEU LUkER LUbE LUNG 

1626 MAL NEC BRUNCH/LUNG NEC 

1029 MAL NbC bRLNCH/LUNG NUS 

1030 MAL NEL PAklETAL PLEURA 
lb3i MAL NEU VISCERAL PLELRA 
lb;>b MAL 1G NtUPL PLEUKA NbC 
163* MALIb NbUPL PLbUkA NUS 
Ib42 MAL Ntt AN 1 MEDIASTINUM 
1643 MAL NEL POaT MtUlAST 1NUM 
l64d MAL NEU Mb 1 A ST I NUM NEC 
1649 MAL NEU MEOI AST 1NUM NUS 
1656 MAL NEL THLR AX/RE SP NEC 
10D9 MAL NEU RESP SYSTEM NUS 
1*51 MALIGN ^EUFL THUKAX 
1*70 SECUNUARY HAL 1G NEU LUNb 
19/1 SEC HAL NEL MEU1AST1NUM 
1972 SECCND F Al 1G NEU PLELRA 
1*73 SEC MAL 1G NEU RESP NEC 

2122 BENIGN NbO TRACHEA 

2123 BENIGN NEU BRUNC HUS/LUNG 

2124 BENIGN NEUPL ASM PLEURA 

2125 BENIGN NEU MEDIASTINUM 
212B BENIGN NEO RESP SYS NEC 
2129 BENIGN NEO RESP SYS NUS 
2133 BEN NEO R 1 BS/ST ERN/CLAV 
2142 L1PLMA IN T kATHURAC 1C 
2^11 CA IN SITU TRACHEA 

2312 CA IN SITU BRONCHUS/LUNG 

2:>ld CA IN SITU RESP SY* NEC 

*31* CA IN SITU RESP SYS NUS 

2357 UNC BEHAV NEU LUNG 

2350 UNC bEHAV NEU PLEURA 

2359 LNC bEHAV NEU RESP NEC 

2391 KESFIRATURY NEOPLASM NUS 

JU61 PSYCHOGENIC RESP1R U1S 

4151 PLLHUN EMBUL1 SM/ INFARCT 

46410 AC TKACbElTIS NO UbSTRUC 

46411 AC TRACbb 1 T IS W OBSTRUCT 
4o60 ACLTE BRONCHITIS 

4661 ACLTE BRUNCH 1UL 1 T IS 

4600 ALEN0V1RAL PNtUMUN I A 

4d01 kESP SYNCYT VIRAL PNEUM 

4602 PAR INFLLbNZA VIRAL PNEUM 

4tiOd VIRAL PNEUMONIA NtC 

4b09 VIRAL PNEUMONIA NUS 

4ol PNbUMOCCCCAL PNEUMONIA 

4ti20 K. PNEUMONIAE PNEUMONIA 

4621 P Sb LUUMCNAL PNbUMONIA 

462* H • 1 NFLUbNi AE PNEUMUNIA 

4d2J S TREPTLC LCCAL PNEUMUNIA 



350 



Table 7 (Continued) 



Code English Description 

4824 a 1 APH t LOCOCC AL PNEUMONIA 

4d*b bAL It R I AL FNblMMA Ntt 

4o29 bAC 1 1 K 1 aL ehclMJMA NUS 

463 PNbUMuM A i LKGAN1SM NbC 

4841 PhbCM h CYTLPtG 1NCL U1S 

4d43 PNt LMGN 1 A IN KFGLP COUGH 

4d43 PNbUMLNlA IN ANTHRAX 

4846 PNbCM IN ASPtRGl LLUS IS 

4647 PNtGM IN CJ TH SYS MYCLSL S 

4bHd P Nt CM IN iNhtL I LIS Ntt 

46b dRONCLPNbUMuNlA LRG NJS 

466 PNt UMUN i A t lkGANISM NUS 

487C 1 NP LCtNZA hlTH PNbLMUNl A 

490 bRUNChlTIS NlS 

4*10 ^lMFLb GHR bkLNCF.ITIS 

4911 MUCLPLRUL CHR fcRCNCHlTIS 

4912 UbSTRUCT Ch* thUNCHlTIS 

4918 CHRLN1C dRuNCh 1 1 1 S NEC 

4919 cHROnIC bKLNalllS NGS 

4920 thPHtStMAlLGi eLtd 
4928 bMPHY StMA Nt C 

493CC t AT ASTHMA R/L STAT ASTri 

49301 tXT AS1HHA h STATUS AST H 

49310 INT ASTHMA H/L STAT ASTH 

49311 INT ASTHMA * STATUS ASTH 

49390 AbThMA W/U STATUS ASTHM 

49391 ASTHMA W STATLS ASTHMAT 
494 BRONCHlbCTASIS 

4950 F ARMbR S 1 LUNG 

4951 bAGASSUSIS 

4952 blRU-FANCltRS 1 LLNG 

4953 SUBbRGSIS 

4954 MALT WORKER S ' LUNb 
49d5 MUSHRUUM WURKbRS 1 LUNG 

4956 MAPL BARK-STR 1FPRS • LUNG 

4957 M VENT 1LATI0N" FNbUMUN IT 

4958 ALLbRG AL VELl/PNEUM NEC 

4959 ALLbRG ALVELL/FNEUM NUS 
49b CHR AIRWAY UoSTRLcT NbC 
5C0 COAL RURK ERS ' PNEUMGCON 
501 AibESTGSIS 

5C2 SILICA PNECFlCLN NEC 

503 1NUKG OUST FNcLMCCON NbC 

504 OUST PNt UMONUF A T h Y NtC 

505 PNtUMLCUNILSiS NCS 
5060 FUM/VAPUR riRLM/PNEUMUN 
5C61 FUM/VAPUR AC FLLM EObMA 
5062 FUM/VAPUR UP RtSP 1NFLAM 
5Cb3 FUM/VAP AC RtSF CUNU NEC 
5064 FUM/VAPUR ChR RtSP CCNU 
5069 FUM/VAPUR RtbF CLNU NJS 
5C7C FUUU/VUM1T PNtLMCNIT I S 
5071 UlL/bSSENCb PNEUMONITIS 
5078 SGLlU/LlU PNtLhOMT NbC 



Code English Description 

jOdO AC PUL I" A N 1 F D/T RAU 1 AT 

DOtti CPk PUL MaMF U/T RAU1AT 

50db RtSP CUNO: b XT AGtNT NbC 

5089 Kb SF CONU: bXT AGENT NUS 

5100 tMFYbMA WITH FISTULA 

t>10* thPYbMA W/C FISTULA 

5110 PLEURISY W/U EFFUS UR Tb 

5111 b AC T PLEUR/EFFUS NUT T8 
511b PLbLRAL bFFUS NbC NUT Td 
5119 PLbLRAL EFFUSIUN NUS 
3120 SFLNT TENS PNEUMUTHURAX 
512b jPCM PNEUKUTHURAX NbC 

5130 AbSCbSS LF LUNG 

5131 ABSCESS LF MEulASTINCM 
D14 PLLM CONGEST/HYPGSTASIS 
315 PU S T INF L AM PULM PlbRCSlS 
DlbO PLL ALVfeLLAR PRUTblNUSIS 
5161 1C1L PULM HEMOS 1 OLRb S I S 
t)162 PLLf AL V EULAR M1CRUL1TH 
5163 1D1L FIERUj ALVbULlTIS 
3l6d ALVECL FNELMUNUPATHY NEC 
5169 ALVEUL FNtLMUNUPATHY NUS 
5171 RHELMATIC PNEUMONIA 
517^ SYST SCLERCSIS LUNG 01S 
5178 LLNG 1NVULV IN TH U1S 
51bO PLLPGNAR Y CULLAPSb 

5181 INTERSTITIAL EMPHYSEf'A 

3162 CLMPENi A TORY EMPHYSEMA 

5183 PLLPQNAF Y EG* 1NGPH 1L IA 

5184 ACUTE LLNG EOEMA NuS 
D185 PCST TR/UM PULM 1NSUFF1C 
51dd LLNG DISEASE NEC 

5190 T RACHEL 5 TUPY CUMPL1C 

5191 TRACHEA /BRCNCHU S U1S NEC 

5192 MEClAbT IN1T1S 

5193 MEDIASTINUM DISEASE NEC 

5194 UISCRDERS LF DIAPHRAGM 
Dl9d RbSP SYSTEM DISEASE NEC 
5199 RESP SYSTEM DISEASE NUS 
71481 RHELMAT L ID LUNb 

7336 T IE TZE 1 S DISEASE 

7484 CCNGEN 1 T AL CYSTIC LUNG 

7485 AGENtSl* UF LUNG 
/4660 LUNG ANCMALY NUS 
74861 CONGEN ERGNCH It C T AS 1 S 
74669 LLNG ANCMALY NEC 

7488 RESF1RATURY ANOMALY NEC 

7469 RESP1RATURY ANOMALY NUS 

75481 PECTUS EXCAVATUM 

75482 PECTUS CARINA IUM 

7563 RIB STERNUM ANUMAL NEC 

7566 ANOMALIES LF D1AFHRAGM 

7815 CLCBB1NG LF FlNGERb 

76600 RESPIRATORY ABNURM NUS 



351 



Table 7 

Code English Description 

78o01 HlPcRVtNT RAT 1LN 

7o602 ORThOPNEA 

76609 RtSPlRATGRY AtirUkM NEC 

7b6l blKiuLK 

76o2 LuUGri 

7863 HtMLP I Y b 1 S 

7d64 AoNLRMAL SPUTUP 

78652 PAINFUL RESPIRATION 

7666 CHEST SWELLING/MASS/LUMP 

7867 AbNUKMAL CHtil SCUNJS 

7806 H 1 iCUUGH 

7809 RtSP b^/ChtiT SYMP NfcC 

7SJ1 AbN F INOINGS-LLNG FIELD 

7942 AbN PoLMONARY FUNL STUDY 

7951 AbN PAP SMtAK-LTH SITE 

7S55 1 U8EKCUL IN It i I REACTION 

799C ASPhYXI A 

7^91 RESF 1 RaTOR Y FA ILLRt 

8C700 FRACTURE Rib NCS-CLOSEO 

6C701 FRAtTURt ONt Ri6-CL0SEU 

60702 FRACTCRt TWL RIBS-CLOSED 

8C7C3 FRACTCRt THRcE Rlbb-CLGS 

bU704 FRACTURE FCUk RlbS-CLUSE 

BC705 FRACTURE FlVt RltS-CLOSE 

80706 FRACTCRt SIX RIBS-CLOSED 

bC707 FRACTURE SEVEN RIBS-CLOS 

6C706 FA tloHT/MUKt R 1 fc-CLOSED 

80709 FX MULT RlbS NLS-CLOSED 

8071C FRACTURE Rib NCS-OPEN 

60711 FRACTLRt ONt R1B-UPEN 

60712 FRACTURE TwL RlbS-GPEN 

60713 FRACTURE THREE RlbS-GPEN 

60714 FRACTURE FUUR RldS-UPEN 
bC715 FKACTURE FlVt RlbS-UPEN 

80716 FRACTURE SIX RIBS-UPEN 

80717 FRACTURE SEVtN RIBS-UPEN 

80718 FX EIGHT/MURt RIBS-UPEN 
60719 FX MULT RIBS NCS-OPEN 

8072 FRACTURE OF STERNUM-CLOS 

8073 FRACTURE OF STERNUM-OPEN 



(Continued) 

Code English Description 

6071 FLAIL CFEST 

oJ9ol U1SLGCAI STERNUM-CLUSED 

8j971 DISLOCATION SIERNUM-CPEN 

6163 SFRAIN CF Rlbb 

84640 SPRAIN CF STERNUM NLS 

e484 1 SPRAIN STERNOCLAVICULAR 

64812 SPRAIN CHONORUSTERNAL 

d4649 SPRAIN CF STERNUM NEC 

6000 TRACM PNEUMOTHURAX-CLOSt 

6601 TRAUM PNEUKQTHORAX^GPEN 

6o02 TRACM H MO THORAX -CLG SEU 

8603 TRACM HE MO THORAX "OPEN 

6604 TRAUM PNEUMUHEMOTHOR-CL 

6605 TRAUM PhEUKOHEMOl HuR-OPN 
6ol20 LCNG INJURY NOS-CLOSEO 

66121 LCNG CLMUS1UN-CLGSEC 

66122 LCNG LACERAT ION -CLOSED 
86130 LUNG INJURY NOS-OPtN 

66131 LLNG CUMUS1UN-0PEN 

66132 LUNG L ACER AT ION -OPEN 
6o20 DIAPHRAGM INJURY-CLOSED 
6621 DIAPHRAGM INJURY-OPEN 
66221 BRONCHUS 1 N JURY -CLuSED 
66229 1NTRATHCRACIC 1NJ NtC-CL 
86231 BRCNCHU5 INJURY-UPtN 
66239 INT RATHLRAC 1NJ NtC-CPEN 
67402 OPEN WOLND OF TRACHEA 
67412 OPEN HCLNO TRACHE A-CCMPL 
V060 LATE EFF INT INjUR CHEST 

9340 FOREIGN BOGY IN TRACHEA 

9341 FLRE1GN BODY BRONCHUS 
9348 Fe TkACP/BRQNCH/LCNG NEC 
*J49 FB RESPIRATORY TREE NOS 
9471 BURN LARYNX/TRACHEA/LUNG 

9580 AIR EMBCL1SM 

9581 FAT EMBCL1SM 

9587 TRAUM SLBCUTAN tMPHYSEMA 

9973 SURG CLhPL 1C-RE SP 1R SYST 

9991 AIR EMBLL COMP MED CARE 



352 



^ z xz—3oc_j.x<«d ^:ur<-jQ.M2 /Qaa^-" zoa- 

<-»ui3^xz /»zaza.«ifl qqz-^u. «-« 

-jz-ojjo. i j>-<nj < ►-•< _uox:-^to z^i -j o jj ►-a. 

Z 3 ^>-J3uJ.u<-nQ.«JZ ZJUSIKhU'U KOHJiJXZ<^ 

jzj- »o.»-ac-j_j-»uj<3 >- zjj*- i^x>zj>xj»>o3Z aeotx 

• -J -i u.aeo.-* tr> !->— < x-> x i uj jjajjioja x_j— • 
x»-i><it-<>.zt >-< a < jjoj j o-*qc<«z-*3 axzj< 

a.-* ~»^«^,3!XX3^-^X3aJX.iJ J_J-U J«ZZi<» ->-» <X 

< — Z-<Z->3Cacac<<z jjaJiaaacuo<jcaj u><oc3<aj.jH"^o»--^a.^Jac 
-»33<3^Kixa£Qca.a.ja ^<c/>,3 ^>>woacojuza. <i jo<-<lu 
ojj-^ac-^u3a.a.iz<3a.^--JO'Jaiz-ijj xoa. *-3<:x3 i x 

Xh-3*— «u.<<aa.— 3<lu »jj.uxa£»X3.ii*-«->oQac33:*o< 
u. <jj<ae-u«*-*<<3Za.~-*— -o < f- jzujo ji ->i iz 

E jHOJUaa3Q-^ tJ3203'^U0V)./1>j >-<M'/lOJlHO<Q.Oa 

<u >j-^a.-«x uo"« a£ce-x_u«^~*«Li-u — «-uxa. </i «»— -^ul'oj^oj 

>, ^X^X-' 3-OCXUJX-IX-«-.J;j JU« <«Z2/lQ<<JJt-<JC X-O 

bO U.f-Ui*ilXWf(»«J>«iWja^"»-"- tE.3E.UC Xt£QL,.«JUJl»J»-» OtUtv»«HX ULU.-0. 

^ u^ai-jcjjuHQiKiacaxzj'j'jjajj i £U3dj3^u3 : j<x 

>> ->'ijuj'-o-Juj - -o_jt-i:^ij'jjjjajaixxxiiUiju><<zij-<ioi-«< 

4-> 

i- 



a. 

CO 



o 

00 

to 
i~ 

Q> 

(V ~o 

S 12 >• -J ^ZZJZ <- -JOJ 

K- •<- ^33 £xiZ -U33aJ3 J _U3C U U >--U 

° Cfl 3I« Z 3Z3 J«hZh >-_3l3 >- Z3VOQC OJ II- 

_ W X>-*- 3 -*<X XXZ '■/> t-33 Z 3*^ 

c °* >-X < — »0 -^V/lh--«_>-*<^0 3H-3^> O. 03JU VI 

re 5 X»— X h- J<Zi->'-»OJJJ h^J3 3 Z^OJlu Z 3 

Q h- 3'^ <ZoJJ3i3^-«jyi o X -< 3 -JZ Z3'JJ> 

to u U.—J3 »— xoxujacjj-J .uJjjUuLU a»>- -j>-<u 3— «-u<x 

k u.3Q.r^zzo eta a«zz<3ZJ •/» <-i oc* -*-zac3 

<T3 C 3 -<>-3<3<<i -J Z 33JC OZJO. U.JC3Z-<tJ^< 3»- 

tu ? Z-UXi._J-<£X-i2_J^-<JJ30_JX JZX3<J 3aJ»-3<UJZ<XZX'J 

to a. ^oz-j '-^a,'-t-3j<o- , LUjz j jLt_3i) _j —«-«>- a/>«u.z^t3iu 

— /»Z3-«"3 X'^>< H(Jll3I_l 3U_ JJ»— X:XJ>— <«-•»— u _j-*a,-* < 

j>-yM u_j < jj^-*x*~>>— x. j J« x — • n «* x _J 

-»X~«J-« ItlZl 5^3<JJ>- -U -> UZJJJJUJ<ZJJZ3X 

a jj<xz j*-_j-< jxuxz <xaj'^<<zzxja,j«j<(3.«< 

^ »— KlU 'J — < «>-C3-Q liv — jp- OXI J'JU .J 73-J-»-^ <— « UX — < 

oc ~ 3,jj «j3^-«33<xx x_j x>-acjj j_jt3-x-oy>acac< jj o _>o 3^j 

° ^ XZt-4X-»4ZZ-<J Jj<iJXH£iJa. jj-*— « U JJ X'O ZZOZ JJZZ JJCV 

u_ J jj >.».x>->UCL»'34<IJia 1(J.JJZ3IJJIIJX33Z3ZZ3JZ13 

O 5 * it <Q CZ JIX J X t-3>-lL UJJ Jjnf-ZZ'—I J«3C J1C3JXX JK " 



to 



co 03 

i $3 

o J 

+j 3 OOh\hn n^H^^T* HJ* J^r* ^C7» -^^J-n^D J> f\jXJ T» 

0) to x 
q 1*- 3 
o 

o 

Q 



353 



■ft uJ «-» Z >»>-jj uj uj n 

,r >ja ujo-o*- y»o 3J ;/> £ZO XaCiJO JuJZ 
<3 JJ"D ZX3J^3jJ jj>- jJ^-3 "D<.U<— «0<JJ<l5< 

1ZZ JJZJjJZZUM3zy)ju.Mk.O'jK«ajO<J 
4-J3 H'ilJ i u UJVJ U Q. 0_>(_J ^ JO.J •« OX 
U<'JJ-^OJOa3\ijZ^'/)ZZ«ZH>3iJ I ujjjh-UX JJ hjh £ 

3ezao<Q3acao-ifla'>—«'/»«^za)*-H^ ^.<x»— (✓>»——« 
zaz^-a.^ -oz>— o«— »— -u jj »333Xuoujujujx^XLur 

>>>_i Oj£ JJ3 JJ-UiJ IS JjJ'JIJiJJI U 
> - i 3JXj(4ZZJl)^jJjjJOZ4jj JJJJ Z2<JlZlw)J 
>^QC<jJ<Z10./>uj JVJi^iJ jjaOJaiO I XJQ I UJ 

u.o<>— jj-»rt^Zij ^vivi z3d<J<<»-i j z— » • uj^ 

^">0 JD>->— < Z— <-• ^ J<JU H-OkL-tOaiU 

Z O.JJOJXZ <0 JUUO Jt- ajr-^-^ae 

JJ<— <U_(^ac <jj-U< X<<-<-^>^-^^'< OX<Z««XUJ»— 
< '- — '-J XJUU«JUUU,U-"JJUJ-ZHZJK"NJ ZO 

<—-!-»•»< JJ JaJZ-Ui— laJUJvlj -i UXJ< 

UUVIHdOMX^M __J ^ id I I I I I (JIM M 

J<aj»<xx«aJ<Z"-<<I»-XIXKX>-aaaiO^ZuJ^^< 
x > » _j -j jj uj jj s*oc x 3 a ac 2 o 3 o o o jj uj 3 »- a a. as 3 ac o 3 i 3 ae 



m -n * «r ^ ^- * >r ^ >r * ^ r^. r«. r*. r>- r- r- p» r- r» r- r«- p» r- r- r» f»- a* 



O-O jc >" si Z o ^ >■ 

NO >- >-'iiUiJ u>*ZZ-l!Z3 JJ XX i^OUi/lQC 

~«aJ X IZJ</ KJZOaZ^ Z 33 X-UUJ JJ*-i<~> 

JZ 3>- 3 J3Z -*<3»— -0-«f-<-> ZJ 3ZZJ44J 

< *—:£>-»—<•>< <_j»— v0uO<>— < jjo —«•-/> — » xz 

— «^ OOr^oJZJU^XO. uOO-^ <QCZ3 »— 3 iDXX-Juj 

X JJ 'Ui-JDIX -o— .uj_J3 iJ»X;xaJ (X '-"<-> O-JQCZ 

_3 ._i jjt- ujojcuj<'^<qc<ujx-«zujxox << _ia£Z< 3 

-O >»ZiJJI«.SJ>l LJIJ3>-Q.33 '-9-«aC <3-*3C-J^ 
XXZ£Z><JdJJXJZ3UJiJJlU< QC3 KJZ30>Z£)- -J»— 
<Z J JQXZJ<'- >-h-0CQC<O<JCX -JX"^_J JJXX-^-^»-< < 

»;^p-^-^<>-Z'3C ax-fl jj^-r^-Q6_j_j< h-jt-a*- ««sixoe 
u£'_>oo.jae>-»— ko<m>.><u'xh ujv<aix^ o'-oai^'U ai 

l— ^JJ U JJ <llX ^ X JLLLX^f- !4^£iJXUtja.ti.4t/inX>JXh-U. 
/)_IJJ Jr-J<t>-|- LJ *- U.UJ UO«J <i_J_J JC_J— JJtJ^l— ( 

_>*->-— J < J jj< UO</>«'J 2<X»<X<< .UZ JJ-» JJJJ r-XO 
J'l— Ul'-JUJ :UJ:UJ U_J JJi— hi£J J^t'JJUJH 

X3<J iJ< jJO'JJ 'JJCX»-»<J < X-O 333 U 

ZXJJJXJJX^J YZZZXXS^Z^JXJ h-yivi^aCjCJC J£u£< 

>-►— — «o<jjx— < jj—«-<u >->->- xio ^i^>--^ jjz j<«j-^z— «jjxx*- jjoc 
x-ox-»oxx3x->-»f- taci£ZHa>K^ri3ZZJ<ai ^>X3 

< JJJJX _J»-_3 Z 3-3^<«*h- J_j jj<>-»— >-3C3-*^ JCUJ>— XK JJ>— X 



2 >J3 JJO />►- t/>o 3J » XZJ *<QC'JJ J J>_UZ 
<3 jj "3 2X3j»-3jj -O*- jJ>-_lI»— 3^3<-U<— < J<.jJ<.3< 
■>■— < aZZ 'aJ2'JJJZZ'J-«32^JU.Hf-uo«<<JJU<J 

<>— ->o jjjjo />lu luu jj a. ouj <xou < ji 
j<u-<jJ3aOdjz i^izzxz»->3ij i u.u*— ox-u r-ut- z: 

< JJ XO^^>" J w U«-«^ UU>OU4^^ Ur- I -/> LU»— JJ SI 
ZlZ»-a.-< 1Z>™ 3h-*-jjjj X»333X.njjjjjjX.rtXJJX 
aJ_3 D'J J JDJjiJ^J 2) JaJJJXJaJJZaJ 

>• — '-> JXX<XXdJO^Jj JJ.J<*azZjJ aJJJ XZ4JI ZIJJ 

>-*-a£< j<zaa^uj j^^jjjjjaoj jjoaux j i jj 
3"Dae^3- _J3>->— z— u<jj n- HOa.y)ja.iJ 

Z UJiJ^Z O JiJJ JO>- u.</>^uJ*-*-</>3e M 

Qat3— « jJ<-«0_J*a£< JJ jj<X<<<v/»*-t/V/>< OKZ41 jjt— 

>--J_J<< JJJJJJZ-U»— 33 XJJXZO/)J U<3< 

<X> jJXX-^bOhO 32<^i2i-jc>-f-K-JljJ 3 acu.>Q3Sj 

UUVI Li. U» _J^ ^»'4Jt/)t/)MI «J 1 1J»*' i-i' '«JOJ 

-"l^IiuUJEOJ-HjJQjJXHiJ'JU Z^ZZZZHII-ZZJ 
J<UJ>->-KXX^UJ<Z-<«Xr'XIXX»<h.JJ'DJ^2'aJi/i^t-< 

Q.»>_j-jajujjj-oacQC jaxjcu ji_»i_n-»ujaJX3^a3a.33C3-^JC jJ3ae 



.-n m -o j- & ^ j» & >r ^» 4- t*- n- r* r- f*- r- r»» f*- r* r» r*- f- p- i*. r«- o 



o-o oc >- z «-> >- >- 

>- >>jjjJO iJ>£ZaJZD UJ XO. ^)UJi^X 

~>JJ X ZZJ<^ KOI33I3H Z 33 O.UJujJJ-^0 

-JZ 3>- 3 J3Z «<3H— *3~«^0 ZO 3ZZJ<<ii 

< >— X>-t— < < -J3 <-!*-<^*/K*-<OJ',J — • O.Z 

— ^ ->ox^ojjz_jo«*aca. <^3~« <acZ3 >-3 sxxj'jj 
x-u 'jjKaaxx ">-*jj.J3Jjxacaj <x <3jzz 

3_t JUf-ajwJ jcuj<-^<ac<ajX-^Z -UQ.OO. << _jqcz< 3 

s) y»z.ijji«jj>i 'ijxjovxaa o-^oc <3**x-j** 

iXXXXC>JJJJ0CJZ3uJiiJXJ< UC3 JCJZQ3>ZX^- — l>— 
<ZJ3 JQCZO<i- >-r-TCaC< -><0C»< _ii^3JjXa-<HiflH« 

o-^.jc o x-o jj« act— qc-j-j^ h-JXcjH <wiac 

OC Ji-><J_JQC>-^-*<3<-^>-XO , JC^- UJV<OIXi/> '_>^OLU"^UJ UJ 

•— «*OJJLiaj <*.UL ^. x._jij_ a-u_*i— U,^> J.LUXVJI— »U»U»-«.^»<* Jt_J J»r-U. 
^iJJJJ^J^A>-(- _J >• U.UJ U'OO XJJJC J"JOJU^U 
>- Z-«"JC* JJCX / )U.J k -JXX J J424JJ JiJ'Jt -U 
Jf— >-•— J 3JJ iJ4'U J<t/l«<J ^"4TC>-Jt«< J2U-tJJ.il H-XO 

U.X- Jli-jajQ U _J JJ_J :J'JU>-Xh— •-"OC'JJ-i. JU JO-^ 
«<3 JJ <? 'JJJJJ UJOC-^ J < I3Jh1 ./l 333 -> 

Z X_J_J-nC_jOJC njXZZXXXD^Z^JX'J ^- /1/1<0CaCJCTCX< 
— «J< ua.»^JJ-*<3>-^>--u3 V>^>— UZ JJ^Z-^ J J.XHJJX 

jc i £-<jizarjji-x j:xz'-3>x^rx3Z zj<3z />zo 
J3x j>3Jxn-< j /ijjja-o-jxj-ooajx-x-tn^aaoH 



XZ3X3^J«< ^333^1 *X XHJ<^3<»> 

z j ijj<^ s jj jjxz wu tzaxa/ijxza a</> 

3KOJ<Za 3kO.J33i->J<3 3 'JJO.UJJ »— J 
X"— >— S* X J»- UJX J J*-'') UJJ"— 

«-<3«».zOt-<3MH3Z<-*J«HH <U— i -OX OZ <<->'_> X 

ijtiUx jj^<x jxj i i xa. i x«j^ jx— j-«»— i i i — »- 
i t i i i i i < i i i i >»>» jj i >• i i DZuitozo-fl^uJi flxa 
xxxxxxx-uxxxxi— •— t • • i i i i i i i — « i i 

JJJJJJJJJJJJ»h»»3333333333333J 
h3333333«-« <*<TXXXXXXXXXXXXX 
lU.U.a.li3333333JJ>JOUJJJJJJJJd J3X33CQ33X 
ZZZZZ303 J0Q3 < Z ZZ ZZZZ *-^-< 

^-.^MZZZZZZZ«OI3K333333aa.u.a.u.lu.a. 

33JJ3JJ3J333333JJ33Xa.u.XU.u.a,J33333J 



SSSUJlOODSSJ) SiSO S03S1SS1IS3COS2I11IIXIIOS 3QX -3D 



<n m tf > o w ^ ir> ^ m <j o ^ rn * in o ^ ^* »n o fM n i ^ »r» ^ 



O0O00O0OJOO03000O0000OO330O0a0000 



ZK Xi- X xxx»— xzxxx»— z 

t^3><3iflJ<Z3Q3^J<^333'/) XX XI— X 

j<z a jjlux*: jujjjxz oj zza<o^u< 
JJX33 at— ajjz3*-o»- x-u j'j^-o*- j<j o ujujx 
< o»aj xh-»- ^ 3xj^- <s> ac-jH- jjx a j>-a jj 

— f>x> Uji^iZQ J3^IZ3IJ3^ZaaJlQ£i-i- ^ 
Z^ZOX-3«^»-3ZI-<J«H3Z<-«sjMh.y) <JJ71IZa 

aaaj3zujcuza • i <x i ta i i xx • I3zok-43-h3z 

HtU I I I I I i I >->-X • >— t • OU'JJ I J I I 3ZJJIUI3 I I 
JulXXXXXXXiflvl U^Tl'^^aiJJ I UJJJO I I I I I I I XX 
►—jj33jjjj.jjjjujjj.jj-*-* i mmm««zzuujz jjaji/)^^) /lvi-owir— 
OZ"« J JJ J J J JXXXXXXX JJZ £ZJ3'JJJ33JJ 
'JJX Q.Q.a.4aO.Q.3333333flUZ "Q ZZZZZZZ — 
a. i.JLXi.i.jL, jjiu u jjjj jjujf-— Df-jja j-u- 

3J J J J J JJ J JiailXll J'J- J 
/)JJ JJ JJOJ 

> z o »- »- h- »- f- a. x x a a. a. a. x x x x x x x z z 

j£3h •<<<<<<OJ 
-UXXXXXXXXXZZZXXZZXXZXXXXXXXXCXX J J 

XXX XX XX XX XXXXXXXXXXXX Jt XX X XXX 33 J3 

j^<Q.a.ia.ia.iaaiQ.aia.aaQ.Q.a.iQ.aina.a.a , ->- 



NN*3033030HH-^H-<M^'35tHiaSa5*3»U , 'J>7 , > ( 7*30 
H1100J030000 30000300300000000300HH 



>300 3300003a0330303U0003J300000JO 



><XXt- LU xt <✓» << <^>X V) 2 

ZOOS/ 33 VI 32"— < < ihj jj J y»o -"O 3 

^ JJ <— ' J32Z J/l ~ 2Q3 «/V/>uj</>-* jj >— Z — 

2 3r-3»- 2 << >t3Q 2-» Z<3 3 i32-<^2 3 »- 

-»OC-J»- *X X»— J J-O TC3«^-*< IDtl 3«— Ohejjx7)J . < >- Z <J 

UO^I tZ3><a^aQ.3< JJvJH-Z-* OOUJ33 J-^ ZZ30 <3>^«Zt-J<3 — > < 

X— 'J-«*-0<3 O JJ 2— H>-«OZ ZOZoiUJ Z 30 JJZ3.QC J2-*Za~«3_JZ ill 

<II LJ JhU^ IXJI^iJ J-'U.iZ J J UJXZ^JX^ '.J Jt^-D VI U. 

< I 211 I liJlXHH -<3iJii<4JJ3£JjJ Q.Q. 32 23d J»— -*(J"> X30»flh^ < 

J3-- 2 -3 ^> <JJ/)Z2£3JCKSZrjJ32 — • -0 23 0. U JZ ZJ>»-3 Jj2-*V13 ♦- 

.2 -J 3ZJJZ JI3XJJ< Jr- j*-JJCL2 J3-*«3-»-*0CZ-*uJa.<:t: J JJZa. J u.o.3 uvijj 
i-KII I I I I I I | 32-J32>-02 a UJO^Jl^< iJ322XZu.d 21 J JZ-"— 

JiJJO JJOJJJJaJllt-<t<iy) U. -00 3< 3-* jjh--«— .y>i— Z jjCL»-3 > s »- 
KX<< UJJJJJJ V u jj 2 aJ^3-»3£tI-*J<H-2<3> <3-**-J -<>*3CU.u»-*2 

UXOJC.K2222222^>U>>>-^><JH ^J7)J)^I JI^QZ JJ<< -"23I33J32-* 

*x c^-^acac jCTC_n> r »t-n^i< «<«3fl>iaa -t-zzziiu- aj j 

"X (X S.Il'Oa3)1]fi>>4^««4J«'JH^>ijjj£U<JJ^JI<Z a *«'^J^J«J^HJ 

f-^-»->->-'-'-»-H'Hi-Qco3zzzzuuiiZJ3^a.3.Q.J3JJjja>' jj >v>Mia^^/)j 

< 4< <ZZ333JJ£^-«J33JZa,£ZUZZ£Xl,X2\iJQjJiJ JJUJOC 

u jo.jj-oj)^^^n-*j4j_j_jjjx"izciz , ^w>flaczxuj uj-«*juj jjjjujuj«j_j_jQ.a.<Ji^ , '*»a33 
2 wo^uooov) u joj jj-lujj3c.jzj 3 J J«* jjc>--«iac-«— j jz •^zzzzzzuM3^z<^aujj 

c 

•r- 

— . <— <^-<— i— -sj^jr\jrr>rrvr\ jTtr*» J»«^"H"-^«-H-*>j<">J"n"ncO BIS'OS'SSSOOO'H'H-^'^'^hJ* 

00 

a> 

J2 



J zx X»- XX J Z X 

jj 2 z^ax3'^iu<z u»<z x jj xhj< 

cl *x xt— z o<z a ujluxscx x^-jjk^x xk a q.zzqxq^jjx 

:/)ZZ3X3ifl *X X*-a»X33 3*-0L U2QXOi/>a.uJZOX3wO 2 m<3 a UO. JJ 

Z<3 3 JJ XZ3XOVKVJJ Xt—h- i/> 3 3 JJt/1 3 3 UJ ^X 'J>-ZX 3 3*-^ 
3X 3 3»-0<3 3 JJ-O ZJJ/1Z23 3 3H20 3 3»— Z2a<3^3iJZafH-t- 23 
I JJXTC^-i— JJX 3 3K23<^3-»f-3ZXaCH.(- 3ZZXHH <J<3 3JJJI 4JJ^X3Z 
<✓> <J_JiflXiJJZ3t^t- 3ZXZUI3I I <OJ>^ZI I < J Ji/iXixiX 3 Jh^JXmJhi- t I 
-«3X -«3-»*-^> <OJ'/lII I ijj I • I I JL)X-i3-«H^/1XH3^HQ.iiZ^I-'- OJZ-UX JI333D 
^ZjJZJZJZJXmJ^xx I XXXXUJjJiJZiJX33JiJZJZ3^ < JJ-"IJ I I I I I ! 
< I I I I I I 3Z UZJZ3«X<4«Z2 I I I I I ZZI lilt Z3 ><-^3-«>— 3 JuJJJUJJJaj 

k-— «— — r- i • i i i i i acjc jc xxacQC jojjj v/»i/)i/)v/>/ijz uioi jz-)-)j3ua_)_j 

J J JU'JJ'J««<4 43333333^11 JJjJUJUJdJX»r033333 I I I I I I I 33333344 
JJ iJ JJ U ijLUA)-»-'-«>H-'-«-«iiXXXXJ.'-»-ZX^ZZr-'-XAZZ*^^>"> , >^^'UA*Z£ZZuJJJ 
—<—«-^— <^l<lZl^^. < C^l>—r-t—r—r-"-r- J» /li/ivijoyw)— « J_ X 

ZittiltjjjjjTja nJJJl^^uua o o>->- o n o -q a j<x^<<xjj 
jj jjjjjzzzzzzz£xzzzz£ , rx»->-h-^xx'->-(-^r-xzx X3cx.x'«*4'«<x<>*<*4«» 

ZZJ JJ3J J3 JJ3 J3J J44 << J3 J J3 33 JCXZXZXXXX 

33333 33JJJJJ JJ JJ JJ JJ iJUJ JJ JJJJ'U JJZZZZZZZZZZZZZZuJJJ JJJJ JJ..UJJ3333333^-f- 
;)C j£ JC 1CX3CXZ2Z2Z4ZZZ2Z2ZZ33333333333333JJJJJJJZZZZZZZ 

a n -a xi 33 aJniaaa.ia.Q.ia.ian,azzzzzzzzzzzzzzaiiia.iar-i-i-t-HKH.jj 

JJ JJ JJJ JJJJJ JJ 33 
2) oaaaa-Q a j-a aaaoaoa T3aiiD3J3JJJ3J JJJJJJa-o-aaoflasBTJ a s oa/)/> 



—4 ^< — < . — G , — 4 — « ^-4 —4 — < <,—<_4— 4.-4r-4^~~4 — <— 4— 4-^ -«i ^.-^ »ji «i 

300000330 J30a0303U03330000000033003aJ JOJJJ003J303 3>0 



357 



CZXXX 1 - Z £Z X O ZX KH x 

u<^oao^ *x KNj^^xaxKaj z x*oxo^o<z 

ijX2 XI O^Q. ^ < X>— Z 0<Z O wUUX^ 

Q.XIJ'_3f— 3>— -J<3 O XIO.LU3 J^tZJO-rt *X KKaOa J>-l-U2 

/» X_J»- 'Al>< 3 3>— ^ aJ3f-Z43 "3 aj £Z3<3'/I1'U X>— *- >-n 3 
ZOtUD^IliJtQtH^ Z3£^3)- 3K a >d« a Mi/) I'JJ'/»IZJ 
OZ<-*0-*»— ^ <OJirtI3Z<JU^Xl UIXHI- XIX 3 3HZa<-3-"-3ZI 

I I Xi I IJi JK^J I I X-» I — <J J/1XO.JJl.'Xf-r- J£X£JXJI I •«* 
>->- U I >- I I 3ZaJI JI3^m ur^Z3'-3<H3«t-^ <J^ZI I oj I I I I OJ»< 
— 1 >—•—»— i 1 I I I I I « I I ^ I I ^ZiU£jZJZ3><-«3-«-XXI XXXXJJJiJ 
—«—<>-——•— <-»vo^ii^i-o-o -o-n»o>i\/nvi^)< 1 1 1 1 1 1 jZoJZ JZ J«>«<44ZZ I 
»-»»33D33333333JJjNr.H>-^»- | I I I I I I XXXQCXXX O 

«-«««zzxzzzzxxx^izx^aoijuujo«<««a3aj3aji]SiJ 
aj>j juJJU'j'jJU'JaaaaajjfflaJajajaJiijLua)-— xxizizz^hz 

< ZZZZ2ZZ-»h«-^m. -t-.ZZ2ZZZZH^t-h-Kt-ta 

ZIJII3Z3333333HiLU.U.ULa.kLZZZZZZZ333303J33a3303>->-a 

xxxxxxx juujoojzizzzzzzzzzzzzxxi- 

OJ'JJ JOJBDTJ SCO J^iZ£^£iJJJJJJJ JJJJJJJ<< 

ZiZiZZZ ZZZZZZ2333J33J J XI XIJJ ixi xl xl xixl XI XI jJuJxl .2 ZZ 

^JJ^JJ3U.O.XX>J.XU.J33J^3JXXi:xXXX4:z^ZZ£^Z2^Z^^Z3Q3 



sj]ssiia^isssssioaaosssiosissioiasa]flaisi9fid3i<ssa]j)J)iiii33J 



0000 00 3 00O0 00000O00 00 00 00OOO000O0OO00 00 000O0 



ZX X XX <i— ZZXXKh- Z ZX X>- X X»- 

I^3X3'-'IJ<Z33QiflJ<^333^ Xt— 1^3X3 /I ZZ3X3'^ 

0<Z O LUJUX^ uJ LUX Z OJ £Z3X3^U<2 O JJ O XI 

41X33 ^XAiz^N-OKaxoo^o^oo a xix»x33 o»— jxzq 

< 1. JJ X»— >— OX-JH- /> X— uJX 3 3»— O.XI QCH-h- CXX/OX*— >— 

— iuovi ijj^jzo o3^zzaru3^zxtuzxi-i- </» zujuox^ o-j^x 

ZV)Z3X-<3-"-3ZZ«U-«f-3Z<^U-*"/1 <OJ/ZZ3X^3hHZOZ-'3- , i- 
23iii3Z'JJZJZ3 I • <£l 13 1 I XXI X3Z3X-*3-*>-3ZxIXOX33Z<XlJX3 
HtO I I I I I I I >>>>X • >- I I JJU I Jl I 3ZJJZUX3 I I I I I I I I I X I I I t 

jyixxxxxxxut^aj^vi^aixi jojjji i i i i i i atociCQCQCQCXacacjJxacscac 

h-ajJ3-U'jjXlxl.U jjxI"^-^ I mm-^mZ2UUJZ ULUi/> 1 /)</»i/»Ayj^i^->-^-Hr-M»-« i 
OX«*_J_J— I— l_J— I.JXXXXXXX XJZ 24333'ja3JJJJJJJJJJJJJJJ 
'XI 3. lQ.3.aaia.3333333CD£Z CO ZZZZZZZ—mh«^h3333333 

IX JliJ.J,l.ii; JJ U JJJJJJOJ^J — 33*-"-U"9 X'i.LLO.'iiJ.llJJJJUJJ 
-"<XJJJUJJJ-JJJ^JJ-J iJt— r-i- JJOJU^JJ U UXXXXXZXUJ^ JU J J 

JJJJJJJJjJiUlUXJJi- O r- .— f— i 

^» i J JJ J J J J 

>zji-h"-t-HP-h.Hr-»-*-*-H»-aa.axxxxzatzzx^xzzzzzzzzzzzzzz 

X3~ 4«««333333333J3333 
-UX'OXXXXZXXXXXXXXXXXXXXXXXZXXXX CJJJJJJJ JJ-JJ-JJJ 

n<xxxxx<xzxxx rxx^xjcxxxxx^xxxxxxaa Bsaasaassassx 
Q^<xxiaaaaxxaaxxxaxxxxxxxxxxxiXHt-H>->-h-Hi-^>-HH»-K 



-<-n oooooo ooooooo z> ooooooo oo o^oo^ -«-«-<--»'-<'-*—«—«—<-*— «—«—« 

~- 'J O ^ -« — • *-* ~* ~» ~« ^ — • -< — « -» ~« »"•-« — » — • -« -« — »«^ — — -»-^ — »^ — 1 

2*000 00 00 0000 00 00 000 000 000000 000 00 000000 000 



-U JJ S> << <i/1X <S> Z 

33 </» JZ— < — OJO i^J 20 3 

O'J <— > J3ZZ -5<^> — • Z33 j0<^ jj V>-* jj X — • 

<< -.^)-n< >I33 Z-« Z<3 3 -"32H1-Z 3 >- 

JJ^l XO-""< Z3C£ 3»— 3-^X-JOXmvj — > < >- Z 

iaO< lUJ^2-» J3JV33 -J-" XZJJ <a>-^-«Z*-.JO — ' < 

Z~ »->— iQZ ZQZutJJ Z 3SaJZQ.Xj£^ZaM3_jZ (XI 

txjizi —J -*-«a.^z -jj jjxz-*-jx-j ootz^j ✓» at 

~«3 JJJJ<<333X<J-<3 O.O. 3X Z3Q. 133^^1 < 

ZZ3X5£BZroJ3Z Z3 a. U OX Z J>"- J-JI-</1 J r- 

X JJ<-J»-i->r-JJa.Z-J3-«<3«^~«a£Z-«Jja.<X oJ JJZO.JJ U.u.3jJ</»JJ 

3zjoz>jz a. jja>i^)ja7i< jazziiito. zx jj-jx-**- 
-UO.Q.>— <X<Q.""> u.^o 3< 3>^_jo>— — z jJQ.^-3^ »- 
z -u^D- , Jrir- | o<t-z<a>- <3-«»— ^> -o»ocx.ll-«z 

ac— •acacaeae— i ■</>•/>< ««»*37j>taa — •— «zzzx jj— lu — »-j 

<^iJ330uz-^<a'jjozazzaiiiiiic\jJ3ij.u jj jjoc 
jj j_i_j_jjc^iza.z-«v»wOi^acx»^aj uj< jjjj jjaj-uaja_j_ja.o.<j«^ naaj 

XUZ3333<3a:><X-»^^<JJZ »^i»-ZZZZZZ3-^3ZX<ja33JJ3 

a.^iia.ia.>a,j-^oaiiia.jj>-i^Q./>iiaa.iaiLa^ jj u33<x <a_>— 



-o 
c 



c 

o 
o 



00 



u%u\m 

^ 'j\ m o o :a o 0* *n «^ * -*n 3 * *n »n o r>* as o -* a> o j» ^ o ^ eg »n 
O o o ^ ^ ^ rn rv r>i ^ in »n »n *n< o o oj ^4 ^ ^ ^ ^ ♦ ^ fw o o *^ o» «^ 

oooooooo300-'-<-<-<-"'-"-"-'-<-r'f*-» , -J , -rfl--J-*^inifMnnjMn^^r* 



X O Z X XXXI- 

3<Z X -U ^X XHJ<Z333^I 

<u x x»— mx^x xt— a nzzoxaiAjjx^ uj 

- 3><31l4JZaX3(/) Z '-0<3 O iJlUZ3H3l- Z 

-2 3 U«n 3 3 JJ *X O^-ZX 3 Q>- -T> ZJOC-J>— *X 

3 3I-Z3 3 3«- XZ3X3^3oJXaCH-r- Z3 J3^I XZOX3</» 
ac»— 3zxac»-f- o<3 <Jj-niozt-<j-<KJO o jj 

J J-T I I «J_J-/>XjJX 3 Oki^DKmOmh 1 I <X I X3UJX O 3>- 
— '3— «f— ^I^IX— '3— «t— a. UXTC*— »— LlZ ilI JI3U2X I 23 1 I Q.aJXa£^-H- 
ZJ£333ai£JIJ^ <JJ^>I3 I I I I I I r— r-uJ 23 f— 33.33 ^) <O_J»-0X 
I I I I ZZI I I I I Z3X-*3-**-3 JJLU JJuJJj'JJ I hhZ3<H3«4)- 

>-> jju '/iw^ii/ivijzjituijzaaaauajjfl -j 3zjjxoxu 

'JJiUU'jjBUa3J3QI I I I I I I 33030C3<<*-X<XX I I I I I I I 
£.4.4. >~ *->->- >" ~i UJJ kJUJUJU^UJUJ 

"O J 3 «*->- OQ-O Q □ -«—.—.—«—< -.-(J^XXKK^ JJ JXX2ZZ£2Z2 
— >— — — "JC X>— r-f— «— ~jC-jC j£jCQ£JCT£«<^'«*< < *-<*«5 t— 

< <t J J Z>-» ^-3_33CTC XXXYttXl X aOtnOB-DT3 

ZZZZZZZX2ZZUJiJJJaJ 1 iJJJjJJJ3Ja3J»-H.H^h. l -Hp.r-f-HH^H. 
□J333J333D3JJJJJJJIIIIZH < << 

ri£iriziirria.ia.Q.iih"-ht->-f-i-jjjjjjjiiiiaia 

J JJ JJJ JJJJ j 3333333^^ "v/> /luO 

J JJJJJJJJJJUOBODBBDna.D3)ll 331171V)/) /)^)/l OJ JJJJ U JJ JJ JJ 

o. a o. a. o. a. a. o. a. a. a. — *- »- -.-» ^ ac oc tc ae ac ac ac 



419-177 - 



84 — 24 



359 



■zxxx>- Z XZ X J 2X x»- x 

z «u XZ3X3 /vjjxzj ai/ia. ^x x*- 2 *_><z q jjjjx^x x— 

ao^-o^-oo a ojo.lu3 jj^zzsxq^ *x x>— jjx33 OKioizaxo^ 
a: _j>— jjx o "3*- 1 uj3hzo a iu zzqks^jj 3 3 u 

roO^XlaJX^HH Z3X3(3k 3X O 3*-.><3 Q UJv/l I J-i'-OIZQ 3 3»- 

< — 0-*>-i/> <OJ^ID2<JO/lt I lUZQCI— t— LUX O af-ZO^^-o-SZlKHt- 
XX I 13* JK"*3^h I I X-* I — • *-v/i <UJ/l£aiJZX^ • I lUJ^I 
HI >l I 3ZiJt JZ3^iJC^I3-«Ox-(3^y) <w)_JV1X I I jj I I I I JUK-<3-"- 
I »— — ' • * — • I ■ ^ZJ£JIJ23<«3-"-'« I XX <XiJjiJl JIJ 
>. m mm-h/i viy>yi^y»tn.yi«n»^v>^>yiwo^ | I | | I | 3ZaJZ JXJ«K««ZZ I till 
>-»»33333333J03 33>^»-».kh| I I I I i I 3£Q£3£a£3£<XQC OOO _><-> 
M<«<XZZZZZZ3CXaea(X3£^OOUJO'JO«««<3333'333i)2alJJaJaJJJ 
>JJJJJJOJJJJJ3 OSiflllD OiJJdJuJuJ'.UaJJJ-^-*-*-* — -XXIIIIIi- -ZZZZZ 

< ZZZZZZZ-"— • i- ,«^MZZZZZZZfH.Kh.h-»-f. 
L)ZZ223333333u.xit^u.u.u.XXZZZZZ333a3333333333»eOj)fia£ 

r» acocQccxocicj: ouuoouurrxzzizxxxizzr^at^H^ 

ojjjjBjmajjaa(jojoojjzzzzz*zjj3J33J33->JJJJ< , t 
t 2^Z^Z ZZZZZZZ3333D33oJiJaJaJjJaJUJJJjjajiJiiJJaJZZZZZZZ 

O 33333*iUiU.U.U. l ia.3333333a:XKZKXZZZZZZZ*ZZ*ZZZZ3333333 

C5 SJ]a]a).'S3](0 3]2diSaisaDSa2]3aa3as33£J]0£'S3lSCD3}asSdSSa333333J 



"S 5 

3 < 

C J 

■I- 

c * 

o "* 



CO 



en 



< 



«>j >j .>j >g <r\ <*> m *n "O # <*• * >r m in if\ .i\ in in r> >o o o <© •© o -o (*» p- r» p>»f*-p*®4j»»aoa» 



< 00330000300300000000300000003000000000000000000 



2 zx X»— X X XXH- XZXXXH- z zx x>- x x>- x 

O r^3X0^J<Z330^iJ<^3.00Lfl *X Xh- £^3«/ XZ3X0>10< 

Jr ~* u<z a jjujx>£ luujxz lli xz3K3i^u<z a uo<^ a oj-ux 

jO ^ UX33 3Ha.aJZ3H3f-Q.u3ahi3>-u<3 3 UJJJX33 3»-UJXZ3 3^-Q.OJ 

to y. < O. U -O 30£ _JH- 'JJX a 3^-O.UJ *h-r- a. -U 3 s% 

t- J — "^^t zjjiflizQ j3/zz3xo3^zajJZ3:H)- s> tjj^i^i Jj^iza 

± 2^ZQ<H3-.i-3Zt-<U- 3 Z <-«;->-*►- ^> 4JJ^ZZ3<-»3-"-Z3Z-3h»-3Z 

z OOUJ3ZJJZIJZ3I KZIZ3I I XX » IOZ3X- 3-hk3Z'.UZOZ 33Z <ZUI3 I I 

~ h-XO I I I I I I I >->- X I >— I I UJil I O I I 3Z UI JIO I I I I I I I I I X I I I I >->- 

3v^xxxxxxxy)-njj^»y»uioOdjaj i jijju i i i i i i i x xj£o£jc-£ jc oc -u oc oc j£ oc »— r- 

"T ^.Jja U JJUJ.iJ JJ'JJ-U-^-^ I ■— • <^ZZU WZ\JJjJ*S*>S\*Sl S% n<S>\S\>— r-*-^ »— r-r-<«* I < •«* <X «X 

°t ~> <— "4 ~J .J -)-l_f_JTf!£jCtaia£ OiZ Z*3 I JU3UJ'J.JJJJJ<JJJJJJJJJ>» 

UQ. lia.a.lia.3333333.'0'nz X) ZZZZZZZ-«-.m- .3333 J33« 
-L. J1.1.1.1.2.lt.JJ JJ JJ-U'iJ iJJjr— JJ>— UOJ ^tlU.XlLtiliaJ'JUHJUU'J 

-3 JJ JJJJJJJlliliaiJJ- O r-t- 1— r-r-— -< i-i. i Z-^l 

T ^)_J-I .3-1 J JJJ 

71 I 'il "O -Q O 13 n O -Q 13 33 T3 "Q T3 13 33 TC X OC TC TC TC >->->->->->->- J J J'JO'J J J J J J J'J J 

2 > 2 u'-i-r-»-Ki-t-i-t-t-fh.f-i-aaiaaaaajzzjji:xi:zzzzzzzzzzzzzzzz 

S JC^^ <<J««3333333333333333 

UZ2Z£CC££C£Z£Z£C£Z£££CZ£££££Z££JJJJJJJJJJJJJJJJ 
• X —laJ—'—'—'-^—'— >-'—<—<—«—<— <-^-«—» -<—.—.-«—.—,.-.-.—.—.—.— ..^ 

r3 -a «»*.ocxTtTCoc jcac tc.x jc xocx xoc XTCXQCTcac-xocjcae; jcoc-oaa'a a -ossss tjsd tj-q aa 

< 

a. ^ o^>4^* nooiN^*noo^n*^ooH\rnr^^oH\j*i*^03-«^''i*'fl0 3-< 

3 — < NNfOOO3O3O-t-HH-»HHH-5asSJS03»J 1 J 1 ^^7>0OOO3OOHHHH^HH\j\ 
*- <_) -ifnoo000000303000330000000033000HHHH^H-«HHHHH^H-i^ 

^ — • >OOOOJ00030000003000003003000000U00003000000003 



o 

o 
at 
3 



a. 



360 



n << <-nx in 

<— < J3ZZ JoO — 233 i/»t/>jjs/*-»uJ X 

-^i/»< >*X33 Z<3 3 -DZ-o-Z 3 

-1 3C3— ^< r^il 3H Q-'IJUX'IJ »— ^ < Z 

0< UJ J>-Z-« J3JJ33 -J-« ZZ3J <3>^-ZKJ<0 — 

Z— ►->'-OZ Z3ZJJ-JJ Z 33olZaKj£MZ3M3JZ h- 

KJIZtJ 3-»aZZ 'UZZ-^3XJ JJt2t-3 /i 

LU J4<333£J^3 3.2L 31 Z3Q. 3^-~*</» 133^1^ < 

DXXAZZaJJZ — <^> ZJ U JIZJ^-3aJt^/)30-< 

< _J^-0"— jj3-Z_J 3— * <3~»»-«a£ Z— «JJ X<X JJ lilZXoJ U.u.3 JJ 

j3Z>jz a. ju3^-fljiirt< J3zzizu.a zz jj-jx 

3,»— <X<0»^ l^J 3< 3hjonmm^)i-Z JJQ.*-3\ 

j^3-azti'Hj<HZ<3> <3<~»»-o — va^a-u. 
— >acacjcac_j/i^^< «<MOvi>.t3o — zzziujm oj 

Z •« < <l< _J^.O— — U^J'*4vJja.-JJ£, s tf;<£-*-« — »J VI _J<-« _JO*»<^ 

3ZZZZiiaJZJOaaa.a33J3ut3> 3 J >'-ONZZCL^ 
£3333'JZ^-f40J3JZQ.Z£3ZZZ£ZZZNi<OiliJ JJ JJ 



< 



go 
i/>jj 



z-> 

-00 



iiJj-Jja^Zl^-»^^-/>KXXjJ JJ 4 JJuJ JJ jj jjjJO_j_ja.Q. J -^Cl.13 
Z3333<3X>-<1^-««<JUZ •^ZZZZZZ3M3Z£<£Saj3 

aaaa.a>aa/iuxxzzanr-a^aboaaaaaau.3^>ajuj3<4£^ 



I3JiflJ'/) 
J^>3Zjj3jj3 
W3Z-ZZZZ 

•-^rrarx 

«^<33^n< 
ac ac ^ z z oc 
3 3 — o ac «o j 

JJJJ3 jj— i— >sj^X 

_j-jjjx -s>-f>-<-n>— 
cvax <<< 

JJH.^3Q3^Q. 

a.a.z3ajujZjj3 

33<a.IZ»-Q£aJ 

UJ JJ Z 

^ZJ333J3 

jj jJoJjjujjjZ 
JOZZZZZZJ 



<<<<<<<<< 



■o 
c 



c 
o 



»>j -nj m -n t\ f»» c* -h -sj ;\j t\ m 9 © 3) <s> s> co ao 9 33 o o o — * c» 



* <*■ «T j"\ J> X» 



00 



.a 



x o z x xxxi- UM 

J<Z X 1. Li *X XHO<Z333^ 33 

ujx^x kh a azz3<3i^iiix^ at 00 

aJJZOXOtl Z vO<3 J XIO.JJZQH-C3*- z << 

^1 J 3 iJ ^X Jl-ZX 3 3H-7) 33C_1K- *X X*-_J_J 

Z3 3 Ot- XZl3X3^3JJXC£»-»- Z3 J3^I IZ3XO^Q.l 
3ZZQ£f-»- 0<3 I <JJ^X3ZZ-J->-J<3 O JJ 

1 1 < j juiiiiix 3 3HirtaxM3^H 1 1 <x 1 xaujx a a^*uz 

n-<~ 3~«H-tVjJXaC*->- jJZ xlXOX3tS"OX I ro 1 I a.jJX0C>-*- — «3 
33iJZJZJ^ <JJ^1I3I I I I I I uJ:Q>— 3333 -O <UJ(^XZ£ 
ZZI • I I I Z3X-«3"«*-3uJ UuUjJjJJJ • t— ^Z3X-«3-f33 

tJT13Q3'33l I I I I I I 3Q3a33«HZ<III I I I I I I 3Z 
i/t Ji /n^/iy) y)-«i J.J..JU J. « JJ jj jj jjjj JJ 1JZ 

TCaCi— 1CJC XJCOC «*■<*<«* JC 
■«K 3 J 33 3 J YXXXXQCXX JC 3S DaBflDUHX 

ZZZZZZZJJ..UJJJJ XI JJ JJ3333333*- H-r-e-^»- »— »— f— ^*-»- «0 
□333333JJJJJJJ1IIIIII < « <Z 

-J_i-i -J_j_j_i 3333a33vry)y».iy»-oy)Hj 
a. a. x x o. a. o. »— *- »- >— ^- ^- ^- *- (— . «-« ^ « tc ac x -ac is a. 



2 
< 

a. 

o 

bj 
Z 

>* 

o 

< 

OS 

a. 

CO 

bi 
at 



o 



3Z3ZJJ3QCQC 
<X3J3ZZ33 
jjO-J _) OJ JJ 
XZ UJ JJjj 
O3aijoiuzza.a 

<UB0033 
0CD3 JOJ JJ J 
>— _J _J>»>».<< 

z -jj xx*-ae 
o-^a£ -J aco j jj 'jj 

OK'JJO'JJZ Z— O 



X 

-J 



a.— «LJ.x ac < — 

>— JJC JO 31> 
<C JJ 

•«*Z JJJJJJ'J 
Z JJ -UJJ JJ JJJJUJ 

jj-:zzzzzz 
i i i 

jjjjjjjjj 



H »^ ^ -H ^ ^ — « ^ ^ r-« ^ «^ — 1 ^ <^ ^ «^ «^ «^ (NJ ' V 

0303030'J303a033a33300'J3J3000300000333 



r>4 
33 

C3 



— < O^-n-yiT* J3J*3-^ 
Z OOOOOOOO'O 

a. 



o 
a 



361 



3 

Z3 o 
3jJ3 
JZ2 

u<3>->- 
xx jjjj 

<r— 3X X 

< 
Q. 

— <<5<<<t 
JJJJU 



UJ I— 

<Z£-< 

x v^i/i 

ZJJ<^JZ 
3_JiUCLf- 

-ia.x33 

JJ I 

333zx 
jj jj jj < 

2Z2>jj 
X £ 
>»2»3-0 

xxx^a. 

lu UJJX< 

u. 

Z2ZOJS 

-33 3x-« 



i»Z Z J 
Z 3uJ 3 JJ o a 

jj -jo. jja.o «u a z 

O.ZJO woaal uOZuj <3 

3 JJ I I 3 I '^Z3iJ^ZiiiU 

t all JX3UUCV3UJZ I 

4/>333 J3JO.DOJa.U< 

SI I £ J J I I U'J<U 

-«>/ixx xx • i >->■ i i xx 
3aiZZa£^»*Hj 
z»-JO-J3ia: < 
jj </ii/i xi/i— -«-j->33j-x 
x*/» 'xi knzz^O*- 
3aa.u.N-HZ«-«^zz 

X— 33-S)</OXX -MOD 

vac jj -«ujujxx zz 
ujjjx^»-3<->o>o-/v-o33 

Zf— X JCu*'*-*^*^ 433 J J 
JJ33 JJJjaXZZZ2 
— ' .3*— »— J'J3 XXUO 

JJ4.^Lj"-J-iUOU.UU<.^.Ail 

<«<«t^tt/i ji <C<<OUJJlu 
XXXX-J—33— XXO.Q. 
U.U. U.U.U. 33 JJ3Q 9CQ3 3 



z z 

uJZZ JJZ 

fi^ujjjza, jj 

30.Q.UJOQ.Z 
• 330. I 3'JJ 
i/> t • Qi/l | Q. 

i a '/>3 
x—9x-«./i 

XX — X3 
at XZ Z 
uj Xjj jj 

— LUU. ^/l^l X— * 
Si 
UJUJJJUJ JJ*» 

xxxxxx— 
333330J 



</>Z 
3 u 



33 
I I 
2=2 
33 
ZZ 



UJ 



33^» 
JJ 

OJUJX 

xxu 

33 



— r\ ^ -n rri rr> g\ 
~\i "V \J nj <-\j ,-sj ->j rsj r» 



3 

zr< 

33XU 
JZ3aj 
-»UZ 
3>--J 

-Z< wOjj 
-*3UX 
JQJJX J 
-.•jjZ < 
-JX J K 

<I J JJ>— 
*j 

>» £ '* J u 
X X— «4C 

< _J -J 

3<3<Z 
Z£Z£J 
3 3 
JJJJZ 
u JJ JJ JJJJ 



o 

Z 3-/»-> 
3<XUJ3< 
JK3ZZJ 
>x3Z O 

JJ— l/>i/»V, 

3-i—>->-Z 

XQ. >Ty>LOor 
_) < UJ 
zx-»a.o,f- 

3-03 /»«/) 

X"« JJJJ LUX 

a, 

U JJ U U JJ X 
Z 

3 

ZZZZZJ 
JJJ'JUZ 

ZZZZZZ 
U U JJ JJ JJ u 



o -n -nj n 9a*-n 

— — —* -g r>j r\j ->j oj f\( oj 





a 
z 

•< 

o 
r» 

ii 

A 

W 
C5 
<< 

< 

D 
< 

os 

H 

w 

B 

u 

OS 

C 
< 



X 

3 

3 
3 



9 



— r\| cr\ ^ gj (r^ © ^(\) rr> o <^ 
r» ^ r» o> —* <\i oj ^ ^ -r <»■ 



< 

a. 
z 



^»'JJjJ3-03 Z Z 

3-Ot/VjJ3aJ3 JJZZ JJ 

JOO^u^jj ZQ»'JJajZa. 
3-J 3 3 3 3J1 Z Z JJ30. 0. JJ 3 
I 3 -)_J I J34J UQ. I 33a I 
Ln i I J^jjaCLQ^I 13/1 
| a i 333 I (Xi^VSI | jQ 
— ii3 33 ^>-<J3 ( t I 'Jl—* 30 133 <S%*+ 

x-^— 3ox^^^co'nx-<^«x 

JJ XZ ZZXXJJ xz 
JJXJJ JJJJ JJXJJ UJ 

X 3 x •> x • n £t» jj O X 3 > x •> 

X -J «^ -JJ -J JO — « ^ U. J -* UJ 
U> U> lO -/ ) JL. Jt 3 »— U> U. * » LO 

JJ U JJ U JJ*— JJ JJJJ JJJJ JJ JJ JJ 
XX XX XX^- XXX XXX XX 
333333333333333 
*— *— *— f— -h 3 h- r- ^ w r- »— h- 
JJJJUJJZJJOJJUJU 

<<<<< <<<<«<<< 

XXX X X <XXX X XX XX X 

u. u. u. u. u. a. u. u. u. u. u. u. u. u. u. 



03033 3boJ00O330 
3033 -O J3 30 JO J3 30 USS*S^-C 



• 

o 

o 

» 

o 
r» 

v 

a 

SR 
D 

K 

t- 

(fl 
Ed 

DB 

O 

06 
O 



X 

3 
3 



0000030 000 
30 30 30 9 GO 00 9 SO 30 9 



X 
O 



< 

a. 

3 
X 



^ JJUJ3-0 
Q-OV1JJ3 

JJJ3U 
I 333 I 
I I 3 V» 
9«/>un I 9 

X~~«9X 

JJ xz 

JJXJJ UJ 
X32*X> 
XJ«-»JJ 

r— j_ j.^i^> 

jj jj u JJ JJ 
XX XXX 
33333 

33333 
<<<<< 
X X XX X 
U.U.U.U.U. 



JJ3 

<^oj Z 
300ZZ jj 
J3JJ JJQ. 
3 JO.Q.O 
I 333 I 
HI I I /I 
— «vOi/1 339 
X33— 

zzxx 

UJ 

X'-09UJ3 
■~J J3-*^X 
X-«X3r- 
>»X 

U JJJJ 

x^xxx 

JJ333 
—3^— 

iUCJ'JJ 

<<< 

xxxxx 

U.U-U.U.U. 



"O y _T\ 333>3^ >J 
OOOOO 30hh^ 

00003 00000 
99930 JO 99999 



-o 

CD 

c 



c 
o 



00 



a 

a r 
zuj <o 

■JJcOZ JJO 

ojau< 

>• I I xx 
x>->-r-o 
:3 jcx < 
T33a.x 

-Z2 

—.-•03 
r zz 

XOO 
-•XXQ-X 



coeocoso 

o 



Q 
© 

ii 

A 
tti 

Z 

o 

M 

Cfl 

a 

a, 

u 

j 
-< 

a. 



z 

3oJ 3 

jja.3 at 

</>3JJ i/l 

a i ^za 
_jx3jj_j 

U3JXJ 
I ZOO I 
XX I I >■ 
3XI2ZJC 
2t-333 

JJ >— •— Z 
>— •«*— » 

✓1 JiXX 
■-<JUI 

— — J J J 

<I < -«T «S 

ooo-JX 
33 X 
JJJJl 
/» Z •£ < 
— «—•_} j-« 
30JJ3 



^c7»-<— < -\i x: 

CO 
o 



3 



3 

3 
X 

a. 
ai 



< 

X 



o 

v. 
© 

v 



o 
ac 
a 







a 












•< 










a 


z 




Z 













a 


CO 










z 


u. 






u. 




«/» 


Ill 




3 






a. 






a. 


< 




jj 


St 






D 






u 




< 


J 




X 


OU 




3 




X 


aJ 




'O 


_J 


a. 




a. 


-r 


-1 




o 


< 










o 


<— « 


s 


a 






X 


z 




*> 




in 


vO 


x 




JO 


a. 




o 






o 






ac 






a 



3 
Z 

Z 
3 

on 
3 



X 

at 
-J 
a. 



^ g 

* : 

fit 



ex 

M 

ft. 

01 



3 
Z 



C6 

CO 

a 

w 



at 



3 

C 

s »■ 

-3 -i r 
x 

—J o 

< 

x o 

— • CO 3 
<J -« X 
z «-« • 

h .n r> 
x o 

ac 

a 



3 

i/VjJ 
ZX 
«3 
-J 

x-« 
o< 

3u_ 
X 

>- 

xac 

33 



ac< 
>-x 

'-a. 

3uJ 
XX 



COC* 



0) 

u 

03 



01 

■< 
z 
o 

X 

o 
J 

a. 

^ „ w 
<(/> > 



jj«/> 

3<</> 
jj^-3 

Z3 



3>-X 
XX JJ 

JJVJ> 

X JZ 
J43 
Q.3-J 
<0 



H 

O 
D 
01 
H 

GO 
CO 

o 



z 


X 



JJZ3 
Z3Z/I 

o-y> 
JQ.Z< 
3s03*- 

X jj 

✓»*/> x-^ 

< JQCZ 
►->- 3 

cxxxx 

OJX33S 

-lucaa. 
x-«<z 

:j*.>>jj 

3XXXZ 
0CZ33O 



< X-13 

3 3JJ X 

IK 
—i 3 
< 

X w> 

w) sO<r-o x 
Z 3— <— « • 

X JO 

X o 

o 

X 

a 



■-ion 

I-"ZZ 

ox 

zu^s 

3Z«-« uj 
XO^-h-_j 

03XX 
X UU*/)iJ 
XXZZ3UJ 
Ji.'J'JJ^ 

oxx*- 

3f- XX 

X'OOOJJ JJ 

xxzz>->- 

31-3311 
< 0^>3CXXX 
3 30J.Z4.Z 

X300:UjJ 

< 
X 

— <— «— <— »%<rvj 
Z 7>C7»C7^ J*^ 

X 
X 



363 



c 

o 



00 



0J 



at 



*v 
Q 
Z 
< 

© 

ti • 

A 

■Ji 
<5 



S- 
W 
■a 

as 
u: 



a. 

5- 
C/2 



(J 
3 



0> 
O 
O 



"*xlOuJ33Z 
ZZZZZZSX 

a Z3 

3 _g M V} at t/> 

Z33Z ZQ.O. 
XZZ<<< u. 

_ixiuixz 
<ZZ333-<a 

wja.0. r is 

3_J— »«4,jJ<< 

3— «zxzz"> 

XX33 J XI— 

lU'-'-JAJ -J -J 



>4-vj>-\J-n.r\ ,0' , ■--^ 
XlX)X)XI3^ 33X>— 



3 



< 

a. 



x 
a. 



z 

DM 
uJZ 
«Z1 

>-3_i< 

3Z<X 

33X — 

xxi— .» 

JJO. < 

-j »— 

;x_i>-z 
« 

Xl3 Z 
321- 

— «-u ^ac 
xi < nca. 



u 
o 



9) 

i 

00 



>* 

en 

as 

D 

w 

-3 

a. 



22 » 



zz 

XI3ZZ 
ZZ33 
XI XI 

<<zz 
— »xx 
zz 

33-JlXI 

a. a 

JJJN 
U JJ JZ 
ZZ3XI 

iajj 
a— i 
jjzu. 
< <oz 

XXxl— 



— »3 — «->J33 7* ^ 
*o 330 0-«r\l 
X) -3 X» 33 X> Xt CO 

o -a- #• -r 



X 

o 

X 
D 

W 
2 

a. 
u 
a. 



z 

£ 

O 
O 



-uJDaJJOZ 
ZZZZZZ31 

z«iorD 

Dinm y» ag v/> lu»/> 
iXlZ-i— J— Z3 
Z33Z Z1U. 

a. 

—iuLfUJUg ZX»— 
<ZZJ03-*3 

uacL r IN 

O 3 • Z 

0-J-»<aJ<< 

J«-»4Q,ZZ« 

a. jjujzuzjx 

auoaiuajitLU 
H-«zazzj 



m330^ oo 
33T0XI3333CO33'-* 



3 



< 

a. 
»■» 
u 
z 

X 

a. 



x>^x 

'xi 3 z 
aziH 
— xi>^X 
ux'-J u< 



~-<o-< Njxicr -\j 

r«>33 33 330D333333 



© 




<33 
-*xl3xi33Z 

zzzzzzjo: 

3 ZJ 
£«IOI3 
3-«-«t/>X-'»Xli/> 
XIZZ — Jnzq 

Z33Z zau. 

1XZ«< X 

.jxixixzx*- 

<ZZDJ3- 3 

oao. z z\ 

O 3 • X 

QJJ<uj« 

o<<— z— 

0— » za.zz/1 

1- atiQaoaj^ 

XUJJJX<->JE->X 



zjuoiUjjx^i 
H«zaczzj 



X» 33 33 X) 33X1 X»— 



Z 

Z3 

3iXI 
OJZ 
«Z1 

—•—a. 
zz -J 



3Z<3! 



3 
z 



o> 
o 



< 

3 



< 

a. 

-» 
z 
•— 

X 
X 



XIX < 

-J x 
IX -J 

4 J u 
->XZ3 

ixiD Z 
3Z1- 

XL3 .J<Z 
OJ<iTSX 



ZZ 

JJQZZ 
ZZ33 

'XI -U 

«zz 
zz 

33-rxi 
a. a. 

JJJN 
U U'«> £ 

zz J u 
a -J 

JJZU. 
«3Z 
XXXI— 
— «— • 
»1I 



HO-4>>lt)3> -\J 
*33333-<M 
r~x>x)OJ -u X3XI jo 
o >r-r 



o 

X 

o 



o 

X 

a 



-9 
X 
O 



364 



2 <xz j_i*->»>- a -j 
>-y> — •'Jjujqc_j>— >— -^2XX 

>-z>s □---uQ.a.o-ja^ 
a.wo jzzjv)z-<z 

3-«U.3 l0CO3J^3 

■zco-*a.ar.jj< nz^i 3— i 

33Z <ZJ^33a.3>Oi 
Z-*<X_J 33iiJJ QC_J O 
3ZX<OCuJXZZ'JuJ3>m 

a33ZJO.<XJJ<^-<Z< 

ta«< jjz uz 

3ZZU3333JJZ>3JZ 

3a u a. a. a. — < < ac <✓> _jo. ac 



v/1 

a 
z 

a. 
ac 



z 
3 



z»- -> iz 

3^UJ33 
ZJZZZJ 

3 a 3 

-J- IIZZ 

O >rt3D33 
Z- QC-UUJJJLU 
3-/1 





t 




u 




< 




u 




o 












© 








V 




0} 
















CO 








w 




(0 


u 




JJ 


a 


Z 









oz 

Z'-J 
3 

azzzz zz 



33 

r— J 
Z 3C 



0.3.0.0,0. 33 
— « W vJOJ 



2 
3 

-3 
< 



/» u 
Jt'.- 
3U. n 

3 -u 
■« •* «* 



/I | 
<3 



- at 

TC'_J 

-••a: a. 

32 J 

"Q_J ^) 
_> «5 —> 
iSZ 



za 



OCX —i—l m 

•'IJ.UJJX -J 

— i J « -T ^ 

4 < JC/liJ 
< -J 'J J CJ 

-JZ<uuj-Jxt-^0£ 
1 UJJ4SJ3 



U2 H 



— «— < -J- -T -T >T T -T ^ •T~T^X\X\iC\ 



Cfl 

as 
w 
t- 
z 



3 
3 



<— «-«'yiX jj3 ^ 

sj -c/i/iHcirtZZ — 

ji 333^— £)-•-• 
Z <aZt3J^->-V 3_j 

a£«a-»a£3-^zi<iJ 

f-ZX. 3— — JJ003-I33 
< OCX^Z>3JC ZJ 

a^> -joo jzzo^z-z 

3-*U-3 Z«<03-U-^-03 

z-o-«oataj< zzz^ 3 -J 

03Z <XJ^33a3>oJ 
X—<X-J 33ujuJ 3 
3ZZ<3£uJKZZJaJO>— • 
JJ3 -JiiJ— »CQO.O-^_i>a£3 

^33ZJO,<1JJ4^h2< 
II-"* 33 £ 3£ 

3ZIQ3l333jjI>JJ£ 

QO.uao.-<aH«x^jQ.i 



-« O >^ r\J i^t JO JN-^c\i COm 33 

^ ir\ -o m <o o o <o o >o i** f*»r» co >r 

if> ^ u'* tf> \f\ .mr\ ir> ^\ xv (T» »r» x\ x> /*• 



3 
Z 

a 

to 



z 

3 



SB 

z 

/>_U — «o 1 

^jjqci^u.3 
3 uwo i ac 

(->vjJX<3 JJ 
<»<l * «-^3 



Zt-0</»Z OJ 
03-*ol30 Z 
ZJZZZJ 

3 3 3 az 
-j- rrxr ua 

J w03333 ZJ 

Z* QCuJ'OJLUai 3 

3^iZZZZ ZZ 

-JJCOOOOO 33 

Mr— "^"X UOi 

oOac—-J33^ II 
oca. z<«x/iaj 

J3<J JJ 3 

a: x.x. itjo 
x_j Zaj-u_j-u-*ac 

•«3 «»-J_JuJ^»-*^ 



< 



n r<» n in jmt> m x> r» r» m -r» o-^ x "n 

— * ^ «T -T -T » -X C\.C\'S\\£\ 



T3 
CD 
3 
C 



C 

o 



00 



01 



re 



o 

a 
z 
< 

o 
r- 

ii 

A 

u 

< 

at 
C 
as 
f- 
c 

s 

w 

2 
Su 



O 

'3 

a 



3 JO.Z 
UJ 33 jj 
■^2 l i 
3_uxx>- 

JQ.33I 
I I *-«-X 

«SS 

XXuj-UZ 
33IK 
XX33»- 

XXuioj 33 
lujj ZZ3 

XX.XXX 



xxxxx 



OOCC3CC 
2033 20 CO 



<u><3 

332 JO 
X I 

3<*X< 
XX3LX 
3J£J 
JJXaJX 

iQja 

<s> 

t-t-XX. 
ZZ-U3 
»< 33»-< 

3 axzz 

O-O— 

-J 
< 
a. 

— < «0 
O ■'NJ NJ 33 3 
— < i .O 

— « >r>r>x\3j 

ex 

a. 



33 

i 



i 

o 
u 



o 

v 

o 
4 



x " 

^ 2 
2 

? w 
a- 2 
a. 

X 

33 

<S - 
.X X 

»— * 



-H 3 

O X 

o » 

so xi 

o 
o 

(X 

o 



z 

X 

a 



z< 

a ja.z 

jU U3'iJ 

*/)Z I I </l 

3ujxx^ 
ja.33Z 

I I *-*-x 

KK333JJ 

«zz 

XX-JjjZ 

ItOOH 

:=t=2S3 
333333 3y 
XX.UUJ.33 
JJ-UZZ3 

xxxxx 



30 0JJ 



o 

01 

o 

v. 
Q 
2 
•< 

O 

H 

A 
U 

o 
< 



< 



<3<3UJ 

x.jjx _jo. 

3Z-UU3 a 

X t/i I i H 

h-X>-»<X w 

3<X<< < 

XXO.XX , k 

3Q£3Q » 

:UXoJXX ,„ 

f— t— w 

£3.33-13:33 2 

a. -«*.x *"* 

^3-^3-J 

Z'Att- XI U ■ 

JJZ-ZZ " 

2 



XXX X U 
irt^l^KZ 

</><<<<*-x 

l/II'/l 
^■r-i/**- -/■><*--« 

Z H- I— t— 1/13 
333 

at\ »— >— o 

•-3 

X««3^ 
ZZZZZN JO 
UXZIZ2ZN 
r-r-^t— < 

a. 



*h -n rn ?n f*> m ma» 

0* ^ 0^ ^ 3* 0^ 

^ ^ >rvr» 



-« 33 
1X3 
>-X 

«/>3 ulH 

^aea^3s 
i/»lulu3 3 i— 
3azza </>-« 



*-3W> 

ii ic3 

xxz 



XtXXX 
1I<(JJI/M 

ai33*-H 



•-•-xxx 

ZZJJ33 
33»-<< 
XU.Z XX 



O O-HO-* 

XMTNvTy 13 wO 



X 

o 
o 



Q 
O* 
O 

o 

IX 

a 



3 



< 

a. 



x 
o. 



-J —J JJ AJ 
JJJJII 
JJ-UZZJJ 
h- h— «-^<< 

jjixiao-xx 

0033^-1- 
XX 33 
'JUXX'JU 
3333 13 <<< 



33-« 

3303— < 
X 

LUUJ'3 
l— >-Z 
333 
•J-)X 

<<-o 



366 



O) 

C 

+-> 
C 

o 



00 



-Q 



05 
00 



u 

2 

aa 
H 

< 



u 
z 

c 



o 



0* 



XXXX <~) 

;/)<<<<»-X 

~« i/)Zi^ 
\/> h- l/> < 

X i- 

acv >>. o 

x<<<0^x 
itztrs co 

OIIIIZIN 
r- -* 

a. 



< <i*l f*^ ^ 0^ 



3 



< 

a. 

a. 




I 

© 

< 
< 

a: 

H 

W 
<> 

&£• 



33 

u 

2 


06 



3 



X) 
O 



■* '/»!!/) 
N» •/>< H- 

X ^ heyij 

•SOt/lLJtsXSX 

H3ZZ22^<Z 

x<<«3cix 

ZZZZZN CO 
UZZZZZZS 

J«4<£ZZ 

x>— *»^*-*»*» < 
««xzz^ac 



t 



OS 

o 

>» 
a 
z 

o 

M 
A 

W 

< 



L3 



< 




o. 




3C 










Zxi 






z«/>z 


CLU- 




X 


— « J 


^- J 


*-X^ 


</>Z 


x<^ 


z> 




_J 


►— - «zm 


«n i 




jjjt 








->z 


XOJ 




—J uz^o 




X -J XZ>oO-m 


xu-^-xa 












<a.v->«*x-r < 



<o o X» O -O X) rn 
COCO X) X) CO CD 



m 


u 


'D 


XI 


Z 


z 


X 


X 


X 


or 


oz 


a 


ZQ 


z 


3J— • 


X) 




< 


< 








ac— • 


X ^» 


J— «* a 


*-X-lh— 


<jj^<ac >- 


x»a.xo *— 


-•X J 


-<3I1 


Q.aJX0.-«O3 






U>*<X 1IH JU 





3-* 



X 

3 



a 



a. o-^^> 

X 03 X> X) X) X> -O X) 

X 

a. 



IX 

o 



o 

X 

o 



o 



367 



T3 
•V 
3 



C 
O 

o 



cn 



u 
c 
* 
o 



UJ 
C5 
<< 

co 
z 

c 

H 
a. 

a 

CO 
CO 

co 
z 

C5 

to 
o 

H 

at 

a. 

to 

al 



•J 
a 



Q. 




£ 


JQ 




UJ_I 




Zoj 


va 




Z/)Z 


Q.U. 


O on 3 


z 




>» J 




i/>Z 


r< x 










4/» 1 








ZJ 




vJZ 


XUJ 


"s— 








xu»>-x a 


a. 















00 -OrO SO 33 337* 



i/1 
-3 
Z 

Z 

Of 

az 

Z3 



UJ 



z 

x 
a 
z 

3D 



X-^ X 
"3— « 

<JJZ<X >- 

x>q,xj h- 

X /10.»-/1X3X 
Z3 U^X U^-3JJ 
XX^3T£ /1JI 



< 

a. 
—* 
o 
z 

a. 



OO O-O -O © o 

JOS 



0C 
O 

a 
x 
<< 

o 
r» 

ii 

A 

M 

<< 

CO 
03 
CO 

o 
z 



ae 

o 

< 

X 

0. 

CO 
UJ 

OS 

OS 
UJ 
X 
H 

o 



z 



JJ 3 33oJ X OkUt/)< oj'-OZtn 

ZZ 3 lUOJ-0 <_i O I 0. JJ_U Z33> 

-J «t ^ 3JJ SJZOJ^^Z UJ • '-J>;J3cJ N. 
<Xf> _J_j^J Z'JKZO^^ZZJ <XZaJ<X 

rioc j uui — «uj -loin 'jjacxjsjjuj— 
jxujz i i ^> z>»-zu_jaQ.-5iji-zjacia. 

Z<J3 ^2j3 3<^3IJI3Z ~> 3>»*-(_> 1 
<-»ZlL 3— «-• ZJJZ/>I »l -nZZJtl < iJ 

-2-^ z^jc^acuaxjzjz z=»--«.a_>>-xx 
z u->- d-josuizozau^ zx>- 1 

30. X ilJJj— «f— ZZi— -> -•— ^>->"OJSU 

Z DU.< ^Zl<ifla:3^>"^>"^JUZQ3Q£HX- 

J£ 2Z atOf ill »X3«-«33a<ZJ 

uj-n o u_LL»-oa»3r-^f— acac ao -o>»x>-a. 

«-t.-i-«xxx zuz3Z£nzzua<j 

jH3<333ZZZZZ-<jMUf.>-jjOJ<^jj 
Jt-OJ J»OtJ*->^.^«l^«<J*»*<J>C>»X.X:JJJJyj*-X^vJ> 

aaa jzi<«xxxx^zzzz^-r- »-xx xx 
^zjs^ZQCocaa.aaa3JJ3zz<ajos33 



^> 0*n <MO O O O rr> ^ ^ * ,>a m rn ^ O O « C7»-* fO 
r» r* r>- P" <» B ^ CO 30 00 "O <0 CO 50 » 30 © CO CT« O T» CT» C7* CT> o 



Z'_> Jifl 
Z<JJ>--U3 
^1 i^3JZ<ZZ 
"3>— * ZU. -* 
•-Z33ZQ3I-1- 

<a jj-^z<zz 



< LLlX-JJO 

c zozz 
JJ J < 



z 

3 



aiO 
zz 



h-H-XZ Q'Z'JJ JJJJ^ JoOZ/)m -J -J 

a. a. o o'~9t/>x o. <a.<< o << 
qi\^ H«aa.JZjj<ujLUii^o^-Jzzzz 

r-aj-OOaJO.^ <ZUJJ^-»oo^t-Z3Ji0033 

zz jJZac^3K^jjJzo-^a-«^<y»JzzzzHi- 

<-^'JCU} JJ XX_J 3 .JL3iJ>-J. 

_j< zo.zu-jjuj3>* jj>- u. t/><j >->- »z 
u. 'i tj — • *-»uc^»Jt,*.i=jjt.a.-< j» _j ™J *" ~ * 
— « w» ^ •• j<jjj jjxicj_j^j<<ztx«-j>ae 

Z 4YX « <J^>— xih-^yi^-h- <» £t3J>« 

4 3x1 jj zzzx^^/i^i^^^iao^i-ua 

ncr- JdlJ. J J< /)iH'jH'ij>»>»» ««*ZZ<< 
»— J<«JJJZZ3 jj/>av»uljJZ'/»<<ZTCvOVl 
ZI»>3 Ujj Z<Z >JUJJJ -1^33 

•j'jjijsNNnataJo-aaih-ozjJia.^ 

X Zk^XZI oyijJCZ<3/i/)y»ijZJJZZ^^JiJ 

-J 
< 

—i oqhon -no-oo-g-oo *n*"O0* o* , n>0'Oaoc7*JO'» 

o ->jin«o o o ob-do 03J^oc7 s ^'J N C7*3MT>xfa) o tj c» "0 

X 

a. 



X 

a 



X 
Q 



368 



JJ 3 Q3oJ Qg UjjJt< JJJIZ-^ 

Z£ 3 jjjj.* <_j o | O.HOJ Z33>> 

3x?-J 232 XI /VJJZ JJ I V. 

rioco liu i — -JCDO.LLI Luacacu^ujLu— • 

Z -<03 -1:0-0 JI3Z -> C3>^-0/> 

<h2i Z JJZ-" I i I ^^ZZXZ <JJ 

-3— zjfx^ujexjzoz z-»-*<a^»'QCJC 
£ jl>- i>aJ33aJZaZ3UH zoc*- J 

zjo.< -*z xot ^*o^>/»>-7nj JzoaotHKM 
<x jz aco- jjx aez>acz><<>-o.3=o<z_j 

0JJ2:<UJlU-UO3^ CU~3Z~5ZC33a. I-hOCZ 

•-^-^z«j-»ocacac ^azuxxa.zz^a<J 
a>o.3Z;i<<<aeacacaea£zzzzr-*->-xoz x x 



r«» r- n- (*- u 30 3> ao » so to so 3> » co 30 co co a» 3^ a» <7»a^ ^ 



V 



ed) 


O 
•< 




















w 








■M 


C/l 








Con 


NO 










AG 








CO 


M 










a 


Z< JJ»-JJ3 










</> i^3JZ<ZZ < 




o 


a> 






Z'OZZ 


z 




OS 




a < 




JD 
ro 
I— 





-J -<Z <ZZ i/* 


-*uia£ jjjJ 


-1 


H 


»— *-XZ JXJJJJ xl>- 








< 


I/VJTmQlSHJ 


a.<a.<< 





U</1 

zz 

•_> 

3 UJ 
ac ac 

« a. 3 

ft- zijjzx^3i-t-jijzj-ia^<iOjzzzz»-h. u o 

W <JXJ jj «><_J -J <_)UJJ>-_J ^ <t i_J 

w _j< Tca.icj.uj uo>-xi>- ll j >->- a»z a ac 

a ixjtjj u»ac *«"*.*. -J u»_j-j>->-^.-^ jj u. 

i/»f— — i VJ ^ •• _J J JJOJIJ JU44XJCUGC 

:S f3 J>"- U"-<S fl*-!- * £XJJ<<t < X 

r -»J 4 JU JJ £ZX X f » /) Jr-*-OJ J _J 

a .let— J3a.a.a. j< j< />-« jj»-»-- -»— «^^<< jj u 

H I— J<4<JJJ2 Z_3jJ riO^> -Oxl i^X-«XClC3C^1^ 0C 0C 

ZI»>3 3x1 I<0C >4aJJJ -»-»33 Z 

jijjN\\aQ.a.£3LJJ-<Da.i^ozjja.o.»-^ 3 o 

• -< Zh>-IZI /)/>JZZ<3/>-l/>4JZaJZZ-'»"'JJ z 

X 3 J«- OJ.JJ JUUJ _J-> X XI-* XI U— «'-JJ_3_3 JJ UOJ XI — • 

■a- _j<q.'xu_u_ <Tcaca. jj^-zat tc*~ «x.j_jacaca.a» >— 

j -i < 

< ac 

j a. 3o> -«"u u 

Z -> N/lOO O O'TJT) O O D5^^3»7»^"naO'p'Oa34)»* J 

04 — « >»T»a^ir> J*> jrtrti/vxi vf>J>JAir> Xkj^in^r-r-P-^f^r^r^r"* jo >• 

O QC <0 Z 

—i a. >r < 

ac ac 

a o 



369 



Appendix V: Summary of services 
provided by the Commission on 
Professional and Hospital Activities 
under the subcontract 



cm 

1968 Green Road. P.O. Box 1809, Ann Arbor. Michigan 48106 313-769-6511 

800-521-6210 loll free for continental U S A. and Puerto Rico (Michigan, Hawaii, Alaska and Canada should call collect 313-769-6511) 

/V.-' p'p/.r o'jjji'.'af o'* sjvwiU'MJ cy 

lif Amf-L.^n Cai.i-gt- .if t'r>, ■ - ,vi 
Af*fi it ■..■■''eyt" o' Zu'U- • I Am—.i j/i 

»=..••(>%*'-'.;• " 19 November 1981 



Ms. Ann Freedman 

Center for Health Studies 

Yale University 

12 Prospect Place 

New Haven, CT 06520 7-213 
Dear Ann: 

This is a summary of CPHA's activities funded by the Research 
Agreement between Yale University and the Commission on Pro- 
fessional and Hospital Activities under Health Care Financing 
Administration grant number 95-P-97499/1-01 , with amendments 1 
through 3, and by purchase order for data tapes. 

CPHA personnel involved in the project were: Richard Ament, 
Cwen Adams, Jan Dreachslin, Carolyn Grant, John Lowe, Kay Perigo, 
Nancy Robinson, Linda Snodden, and Walter Wood. 

CPHA's part of the project involved three activities: transmission 
of individual patient data, participation on the steering committee, 
and coordination and payment of consultants from the medical 
specialty societies. 

Two data sets were forwarded to Yale. On 27 December 1979, the 
first set of tapes was transmitted containing calendar year 
patient discharge data for 588 hospitals. On 11 July 1980, the 
second set of tapes was forwarded to Yale. These contained July 
through December 1979 patient discharge data for 332 of the 
hospitals in the original transmittal. The 322 hospitals were 
sampled from the original 588 hospitals so as to, as nearly as 
possible, proportionately represent the distribution of short- 
term general hospitals in the United States. 

For the period 30 September 1979 to 30 September 1981, CPHA sent 
representatives to the ICD-9-CM DRG Revision Steering Committee 
meetings, and performed various analytical tasks associated with 
these meetings. Additionally, CPHA coordinated and paid honor- 
ariums, travel, and per diem to consultants on the project from 
various medical specialty societies. 

The price for the data tapes was $34,333. The remaining activities of CPHA 
were under the cost reimbursement contract stated above, not to exceed $87,017. 

It has been a pleasure working with you and the project staff. My best 
regards in your future work. 

Sincerely, 

Walter R. Wood 
Manager 

Research and Statistics 




372 



Appendix VI: List of abbreviations and 
glossary of terms 



Abbreviations 
ADJUST: adjustment 

AGE 18-69: age eighteen through sixty-nine 

AGE 18 + : age eighteen and over 

AGE > = 18: age greater than or equal to eighteen 

AGE < 18: age less than eighteen 

AL: alcoholic 

AMA: against medical advice 

AMI: acute myocardial infarction 

AND/OR C.C.: and or substantial comorbidity and 
complication 

ANY DX: any secondary diagnosis contained on the 
patient's medical record. 

AUTOGRP: automated grouping 

BLDR: bladder 

CARD CATH: cardiac catheterization 

CATH: catheterization 

C.B.D.E.: Common Bile Duct Exploration 

CIRC: circulatory 

CIRR: cirrhosis 

CHF: congestive heart failure 

CML: Conversational Modeling Language 

COMP: remainder of CPHA sample not used in the 
formation of Diagnosis Related Groups 

COMP ANY DX: a complication designated as any 
secondary diagnosis contained on the patient's 
medical record 

CONN: Connective 

CPHA: Commission on Professional and Hospital 
Activities 

CPHA: complete sample from the Commission on 
Professional and Hospital Activities 

DEBRIDE: debridement 

DIAG: diagnosis 

DIFF: differentiated 

DIGES: digestive 

DIGEST: digestive 

DIS: disease 

DISCH: discharge 

DISL: dislocation 

DISORD: disorder 

DRG: diagnosis-related group or terminal group 

DX: secondary diagnosis 

D & C: dilation and curettage of uterus 

EFF: effects 

EX: except 

EXC: except 

EXCL: excludes 



EXPLO: exploration 
EXTREM: extreme 
FIX: fixation 
FX: fracture 

GASTROENT: gastroenteritis 
GEN: generator 
GI: gastrointestinal 

HCFA: Health Care Financing Administration 
HEPA: Hepatitis 

HIGH: high length-of-stay trim point 
HSMG: Health Systems Management Group 
HUMER: humerus 

ICD-9-CM: International Classification of Diseases, 
9th Revision Clinical Modification 

INT: internal 

LOS: length of stay 

LOW: low length-of-stay trim point 

LOWLEG: lower leg 

M: medical DRG 

MAJ: major 

MALIG: malignancy 

METAB: metabolism 

MDC: major diagnostic category 

MISC: miscellaneous 

MUSCSKELET: musculoskeletal 

MUSCSKELETAL: musculoskeletal 

MYELOPROLIF: Myeloproliferative 

NEOPL: neoplasm 

NERV: nerve 

NUTRIT: nutritional 

OR Proc: operating room procedure 

OTHR: other 

P: surgical DRG 

PAS: Professional Activity Study 

PERI: peripheral 

PRINC: principal 

PP: Postpartum 

PROC(S): operating room procedure(s) 

REACT: reaction 

REPL: replacement 

REVIS: revision 

SKN: skin 

SPRNS: sprains 

SS: sum of squares 

STRNS: strains 

SUBCUT: subcutaneous 



374 



SUBST: substance 
STERIL: sterilization 
SYST: system 

TEST: sample of CPHA records used in the formation 
of Diagnosis Related Groups 

TIA: transient ischemic attacks 

TISS: tissue 

TOT: total 

TRIM: all values that lie outside the lower and upper 
points 

UHDDS: Uniform Hospital Discharge Data Set 
UPARM: upper arm 
W: with 

W AGE>70CC: with age 70 or over and substantial 
comorbidity and/or complication 



W AMI OR CHF PDX: with a principal diagnosis of 
acute myocardial infarction or congestive heart failure 

WND: wound 

WO: without 

W/O: without 

WO AGE >70CC: with age less than 70 years and 
substantial without comorbidity and or complication 

WO AMI: without acute myocardial infarction 

WO AMI OR CHF: without a principal diagnosis of 
acute myocardial infarction or congestive heart failure 

WITH CC: with substantial comorbidity and/or 
complication 

W O CC: without substantial comorbidity and/or 
complication 

> 1 HOUR: greater than one hour 



419-177 O - 84 — 25 



375 



Terms 

Additional diagnoses: Secondary diagnoses, problems 
and significant symptoms both related and unrelated 
to the principal diagnosis, which exist at the time of 
the patient's admission or develop during his hospital 
stay. 

Additional procedures: Procedures other than the 
principal procedure performed during an operative 
episode. 

Admission category: The patient's status at admission, 
usually classified as emergency, urgent, or elective. 

Admission date: The month, day, and year the patient 
was admitted to the hospital. 

Admission diagnosis: The diagnosis reported by the 
attending physician at the time the patient is admitted 
to the hospital. 

Admission hour: The hour the patient was admitted to 
the hospital (military 24 clock 0001 through 2400). 

Admission through emergency room: Record of any 
patient either examined or treated in the hospital 
emergency room and then directly admitted to the 
hospital as an inpatient. 

Algorithm: A well defined procedure which when 
routinely applied, leads to a solution of a particular 
class of problems (e.g., guidelines for solving a 
recurrent problem in mathematics). 

Attending physician: The physician legally responsible 
for the care of the patient from the beginning of his 
hospital episode. 

AUTOGRP: An interactive computer system designed 
to facilitate rapid analysis of complex medical 
information. AUTOGRP allows the clinical or 
administrative expertise of the user to be combined 
with sophisticated computer techniques to permit 
rapid information retrieval, hypothesis testing, 
development of norms, and identification of deviant 
cases. This interaction yields results of a uniquely 
high statistical and medical quality, AUTOGRP has 
been used to aid in understanding the process of 
patient care management in a variety of settings in 
order to enhance the effectiveness of decision-making 
from both a medical and management point of view. 

Birthweight: The weight of a newborn or stillborn 
infant recorded at birth in pounds and/or grams. 

Case mix: The relative frequency of different types of 
patients treated at a hospital as defined by principal 
and secondary diagnoses, age, discharge status, 
operating room procedure, and substantial 
comorbidities and complications. . 

Case severity: The manifestation of an illness in a 
particular patient. 

Cause (etiology): That which induces or brings about a 
particular condition or effect. 

Cell frequency: The number of items falling into a 
category in the analyses of count data. 



Classify statement: A statistical algorithm which 
determines the subgrouping which near-optimally 
reduces the level of unexplained variance in a 
dependent variable. 

Clinical coherence: Patient groups expected to evoke a 
set of clinical responses which result in a similar 
pattern of resource use. 

Commission on Professional and Hospital Activities 
(CPHA): A nonprofit, nongovernmental organization 
in Ann Arbor, Michigan established in 1955, whose 
primary objective is better use of clinical information 
in evaluating the quality of medical care. CPHA 
collects, processes, and distributes data on hospital 
utilization for management, research, and evaluation 
purposes. The two main programs of CPHA are 
Professional Activity Study (PAS) and the Medical 
Audit Program (MAP). 

Complexity: Has been used to refer to an interrelated 
but distinct set of patient attributes which include 
severity of illness, prognosis, treatment difficulty, 
need for intervention and resource intensity. Each of 
these concepts has a distinct meaning. 

Severity of illness: Refers to the relative level of 
loss of function and mortality normally caused by a 
particular illness. 

Prognosis: Refers to the probable outcome of an 
illness including the likehood of improvement or 
deterioration in the severity of the illness, the 
likehood for recurrence and the probable life span. 

Treatment difficulty: Refers to the patient 
management problems which a particular illness 
presents to the health care provider. 

Such management problems are associated with 
illnesses requiring sophisticated and technically 
difficult procedures and illnesses requiring close 
monitoring and supervision. 

Need for intervention: Relates to the consequences 
in terms of severity of illness that lack of immediate 
or continuing care would produce. 

Resource intensity: Refers to the relative volume 
and types of diagnostic, therapeutic and bed 
services used in the management of a particular 
illness. 

Consumer: One who is receiving or may receive 
health services. 

Conversational modeling language (CML): A computer 
programming language developed at Yale University 
that was used to construct AUTOGRP and Grouper. 

Database: Collection of information. 

Date of birth: The month, day, and year of the 
patient's birth. This item also contains indicators for 
identifying patients 100 years old or older and for 
identifying stillbirths. 

Death: The end of life or a permanent cessation of all 
vital functions. 



376 



Dependent variables: A variable whose behavior is 
being studied (e.g., length of stay and total direct cost 
of treating a patient). 

Details statement: Provides a cell by cell description 
of the subgroups recommended by a CLASSIFY for 
a specified independent variable. 

Diagnosis: The commonly accepted term used to 
describe a disease. 

Discharge abstract: A summary description about the 
patient's hospitalization prepared upon discharge from 
a hospital. 

Discharge date: The month, day, and year the patient 
was discharged or transferred from the facility or 
died. 

Disease: A condition in which health is impaired. 

Disorder: A morbid physical or mental state. 

Display statement: Provides for all values of a 
specified independent variable occurring in a group, 
the number of observations having that value, the 
dependent variable mean and standard deviation, and 
any labels that have been defined for the variable. 

Disposition (alive or expired): The consequent 
arrangement or event ending a patient's stay in the 
hospital. 

Disposition alive: Includes the following categories: 

Home or self care: The patient was discharged 
home under his own or his family's care. 

Against advice: The patient left against the medical 
advice of the attending physician. 

Short-term hospital: The patient was transferred to 
another short-term hospital. 

Skilled nursing facility (SNF): The patient was 
transferred to a facility certified by the state to 
provide daily skilled nursing care. 

Intermediate care facility (ICF): The patient was 
transferred to a facility certified by the state to 
provide an intermediate level of care (above the 
level of room and board but not at the level of care 
provided by a skilled nursing facility). 

Other facility: The patient was transferred to an 
inpatient health care facility other than those 
defined above (e.g., psychiatric or tuberculosis 
hospital). 

Home health service: The patient was discharged to 
a home health service program such as those 
conducted by hospitals or by health agencies such 
as the Visiting Nurse Association. 

Disposition expired: Includes the following categories: 

Autopsy: An autopsy was performed in the hospital 
or the report of an autopsy performed elsewhere is 
in the patient's medical record. 

Operating room: The patient expired in the 
operating room. 



Postoperative: The circumstances and the time of 
death meet the hospital's definition of 
"postoperative." 

Coroner's case: The patient is a cornor's or 
medical examiner's case. 

Expression: Specifications that serve as decision 
making criteria when used in a logical context, or 
provide a value when used in a computational 
context. 

First and second procedures: Procedures performed in 
addition to the principal episode procedure during the 
patient's hospital stay. 

Frequency: The number of items, or cases that come 
under a particular category or classification. 

Geographical classifications: Areas of the country that 
for reporting purposes are grouped into four regions 
(census regions). 

North Central 

Northeast 

South 

West 

Group statement: Provides a subset of observations 
found in the database. 

Grouper: A computer program that assigns patients to 
DRG categories using medical abstract data. 

Health: Defined by the World Health Organization as 
"a state of complete physical, mental and social well- 
being and not merely the absence of disease or 
infirmity." 

Health resources: Resources utilized in providing 
health care and services including money, manpower, 
equipment, facilities and supplies. 

Histogram statement: Generates a variety of 
histograms and statistics for specified distributions. 

Hospital: An institution whose principal function is 
the provision of inpatient services (diagnostic and 
therapeutic). Hospitals are classified by length of stay, 
type of services provided, teaching status, and 
control. The U.S. hospital system is dominated by 
short-term general hospitals. 

Hospital day of the procedure: The hospital day on 
which the procedure was performed during the 
principal, 2nd, 3rd, or 4th episode (the day of 
admission is day 0). 

Hospital number: The hospital identification number 
which is assigned to each hospital when it begins 
participation in the PAS system. 

Hospital service: The organization of the hospital 
medical staff into departments (divisions) or 
specialties so that it can exercise its delegated 
authority and meet its responsibility to maintain 
proper standards of medical care and to plan for 
continued betterment of that care. 



377 



Independent variable: Variable which is presumed to 
cause, effect, or influence a dependent variable. 

Inpatient: Refers to a patient who has been admitted 
to the hospital at least over night. 

International Classification of Diseases Adapted for 
America, 2nd Edition (HICDA-2): A coding scheme 
used for identifying diagnoses and procedures. 

International Classification of Diseases Adapted for 
America, 8th Edition (ICDA-8): A coding scheme 
used for identifying diagnoses and procedures. 

International Classification of Diseases 9th Revision, 
Clinical Modification: A coding scheme used for 
identifying diagnoses and procedures. This scheme 
replaced both ICDA-8 and HICDA-2 as of 
January 1, 1979. 

Kurtosis: Refers to the relative peakedness (flatness) 
of a distribution that is usually measured by the fourth 
moment of the distribution. 

Locality code: A code which describes the patient's 
residence. 

Major Diagnostic Category (MDQ: All principal 
diagnoses were initially divided into 23 mutually 
exclusive and exhaustive categories based on organ 
system. These categories are mutually exclusive with 
the exception of MDC 12, Diseases and Disorders of 
the Male Reproductive System and MDC 13, 
Diseases and Disorders of the Female Reproductive 
System which include common diagnosis codes that 
involve urogenital problems without reference to sex. 

Major teaching hospital: Has approved residencies in 
at least three of those four specialties described under 
minor teaching. 

Mean (x): Refers to the average group of values. The 
mean is computed by summing all scores x and 
dividing by the total N. 

Minor teaching hospital: Has at least one approved 
residency among the following four specialties: 
internal medicine, obstetrics/gynecology, pediatrics, 
and surgery. 

Need for intervention: Relates to the consequences 
that lack of immediate or continuing care would 
produce. 

Nonteaching hospital: Does not have approved 
residencies in any of the four residencies described 
under minor teaching. 

Observation: The basic unit of analysis. 

Operating physician: The physician who performed 
the procedure during the principal, 2nd, 3rd, or 4th 
episode. 

Operating room procedure (s): Defined based on 
clinical judgement, would in most hospitals be 
performed in the operating room. 

Operative episode: An operative episode is a single 
continuous session during which one or more 
procedures are performed by one primary surgeon. 



Examples 



Operating 


350 


Closed heart valvotomy. 


Room 


0112 


Cerebral meninges 






biopsy. 


Procedures: 


5122 


Total cholecystectomy. 


Non-operating 


3491 


Thoracentiesis. 


Room 


8945 


Pacemaker rate check. 


procedures: 


7534 


Fetal monitoring nos. 



Outlier: Observations which exhibit extreme values of 
the dependent variable. 

Payment source: Includes the following categories: 

Medicare: The payment category defined in Title 
XVIII and Title I of the Federal Medicare Act 
(Public Law 89-971). 

Medicaid: The payment category defined in Title XIX 
of the Federal Medicare Act (Public Law 89-971). 

Title V: Maternal and child health. The payment 
category defined in Title V of the Federal Medicare 
Act (Public Law 89-971). This category applies only 
to females age 60 or younger or males age 21 or 
younger. 

Other government agencies: Any form of payment by 
government agencies, whether local, state, or Federal, 
except Medicare, Medicaid, or Title V (Maternal and 
Child Health). Coded here is CHAMPUS, the 
insurance plan of Federal Government employees, 
including U.S. armed forces dependents. 

Worker's compensation: Payment by Worker's 
Compensation insurance. 

Blue Cross: Payment covered by a Blue Cross plan. 

Insurance company: Payment covered by any private 
or commercial insurance carrier except Blue Cross. 

Self pay: Payment directly by the patient himself. 

Other: Any payment not included above. 

No charge: No payment expected by the hospital. 

Principal diagnosis: "The condition established after 
study to be chiefly responsible for occasioning the 
admission of the patient to the hospital for care." This 
diagnosis is coded using the International Classification 
of Diseases, 9th Revision Clinical Modification. 

Principal operative episode: That episode during 
which the principal procedure took place. It is not 
necessarily the episode which occurred first. 

Principal payment source: The anticipated primary 
source of payment of the patient's hospital bill. 

Principal procedure: That procedure most related to 
the principal diagnosis and one which was performed 
for definitive treatment rather than one performed for 
diagnostic or exploratory purposes, or was necessary 
to take care of a complication. 

Print statement: Will list observation by observation, 
the values of any set of variables or expressions. 



378 



Professional Activity Study (PAS): Represents a 
system of programs that have been developed by 
CPHA to assist hospitals to meet specific data 
requirements. Hospitals submit discharge abstract 
information. The hospitals in turn receive a series of 
monthly, semi-annual, and annual utilization reports. 

PSRO Uniform Hospital Discharge Data Set 
(PHDDS): A more inclusive set of data than the 
UHDDS which is used by the PSRO. 

Race: The self-defined race of the patient as follows: 

White: A person having origins in any of the 
original peoples of Europe, North Africa, or the 
Middle East. 

Black: A person having origins in any of the black 
racial groups of Africa. 

Asian: A person having origins in any of the 
original peoples of the Far East, Southeast Asia, the 
Indian subcontinent, or the Pacific Islands. 

American Indian: A person having origins in any of 
the original peoples of North America, and who 
maintains cultural identification through tribal 
affiliation or community recognition. 

Hispanic: A person of Mexican, Puerto Rican, 
Cuban, Central or South American, or other 
Spanish culture or origin, regardless of race. 

Other: Any option not covered above. 

Readmission: Subsequent admission for the same 
condition. 

Result statement: Provides a summary of the 
subgroups recommended by a CLASSIFY, for the 
specified independent variables. 

Display: A display without the statistics. 

Secondary diagnosis: Secondary diagnosis, problems, 
and important symptoms both related and unrelated 
to the principal diagnosis which either exist at the 
time of the patient's admission or develop during his/ 
her hospitalization. 

Secondary payment source: Anticipated source of 
payment supplemental to the principal payment 
source. 

Severity of illness: Refers to the relative level of loss 
of function and mortality normally caused by a 
particular illness. 

Sex: The patients gender, male or female. 
Short-stay hospital: General and specialty hospitals 
reporting an average length of stay less than thirty 
days. 

Special care unit: A medical care unit in which there 
is appropriate equipment and a concentration of 
physicians, nurses, and others who have special skills 
and experience to provide optimal medical care for 
critically ill patients or continuous care of patients in 
special diagnostic categories. 

Standard deviation: A statistically common measure 
which is the square root of the variance. 



Stats statement: Used to generate the statistics of a 
distribution (number of observations, mean, standard 
deviation, skewness and kurtosis, and the minimum 
and maximum values). 

Substantial comorbidity: A pre-existing condition that 
will, because of their presence with a specific 
principal diagnosis, cause an increase in the length of 
stay by at least one day in approximately 75 percent 
of the cases. 

Substantial complication: A condition that arises 
during the hospital stay that prolongs the length of 
stay by at least one day in approximately 75 percent 
of the cases. 

Sum of squares (SS): The total of the squared 
distances from points X. The sum of squares is 
computed by (X-X)/12 

Transfer: To move the patient to another facility such 
as SNF, another acute care facility. 

Treatment difficulty: The patient management 
problems which a particular illness presents to the 
health care provider. Such management problems are 
associated with illnesses without a clear pattern of 
symptoms, illnesses requiring sophisticated and 
technically difficult procedures and illnesses requiring 
close monitoring and supervision. 

Tree facilities: Allow the user to obtain a summary of 
the grouping done, either in terms of the groups 
formed or in terms of their ability to explain the 
variance in the distribution of the dependent variable 
over some specified initial group. 

Trim points: Observations with abnormally high 
values were excluded from the data base before 
analysis of the mean was done. Trim points were 
selected by excluding all observations that exceed the 
mean by more than three standard deviations. 

Uniform Hospital Discharge Data Set (UHDDS): A 

minimum set of hospital data. The collection of 
UHDDS is required upon discharge for all hospital 
stays reimbursed under Medicare and Medicaid. 

Unrelated surgery: A procedure requiring the 
Operating Room for which there is no diagnosis 
present on the patient record which would explain the 
surgical procedure being performed. 

Urogenital: Pertains to the urinary and reproductive 
organs (e.g., the organs that are responsible in the 
production and excretion of urine together with the 
organs of reproduction. 

Variable statement: Used to create new AUTOGRP 
variables that ai e combinations or variations of 
existing variables. 

Variance (V): The average squared distance of each 
score or value away from the mean. The variance is 
computed by: 



379 



Appendix VII: Available materials 
from the ICD-9-CM project 



Yale School of Organization and Management 

Box 1a New Haven Connecticut 06520 



DATE: December 31, 1981 

TO: Colleague 

FROM: Robert B. Fetter 

SUBJECT : The New ICD-9-CM Diagnosis Related Group (DRGS) 
Classification Scheme 



The Health Systems Management Group of Yale School of 
Organization and Management ICD-9-CM Diagnosis Related Group 
Project Staff would like to announce the completion of the 
New ICD-9-CM Diagnosis Related Group Classification Scheme. 
Under a grant from the Health Care Financing Administration, 
the development or the new ICD-9-CM DRGs has been in 
progress since the Fall of 197 9. The new ICD-9-CM DRGs 
represent a major departure from the earlier 3 83 DRG 
version. 

An order form for the new DRG number assignment computer 
program and associated documentation is attached. 

The Health Systems Management Group (HSMG) is not in a 
position to provide software support. All problems 
associated with the installation and use of the software to 
assign DRGs to patient abstracts are the responsibility of 
the user and HSMG cannot provide any assistance if problems 
arise. The software has been successfully tested and 
installed at several sites. 

These manuals and tapes will be available from the National 
Technical Information Service (N.T.I.S.) later this winter. 
To the best of our knowledge the costs of obtaining these 
materials from N.T.I.S. will be roughly comparable to costs 
quoted here. For further information regarding the 
distribution of these materials from N.T.I.S. write: 
N.T.I.S., 5285 Port Royal Road, Springfield, Virginia 22161. 

For further information please contact in writing Ann T. 
Freedman, Project Director. 



382 



ICD-9-CM Diagnosis Related Groups Documentation 



Volume I; User Manual for ICP-9-CM giaynosls Relateo Q coups 

was designed to familiarize the reader with the New 
Diagnosis Related Group Classification Scheme. This manual 
provides background information on the new system, strategy 
and methodology used in the construction of Diagnosis 
Related Groups and a detailed example of Major Diagnostic 
Category 11: Diseases and Disorders of the Urinary Tract and 
Kidney. Also included are tree diagrams describing the 
structure of this scheme as well as an abbreviated English 
description of DRGs 1 through 467. 

Volume II; Definitions of Diagnosis Related Groups. The 
purpose of this manual is to provide a detailed definition 
of the 467 ICD-9-CM Diagnosis Related Groups. DRGs 1 through 
467 are individually defined according to specific ICD-9-CM 
diagnosis and procedure codes along with their respective 
English descriptions. Also included are diagrams describing 
the structure of the classification scheme. 

Volume III: Transfer Tape for TCP-9-CM Diagnosis Related 

Group Assignment; Software and Tnstanatinn- Manual and User 

Guide for Technical Use. The transfer tape contains the 
software required to assign a DRG number to a given patient 
abstract. Information necessary to install, and understand 
the software is described in the installation manual. The 
first Four Chapters of this manual deal with the 
installation, testing and running of the DRG assignment. 
Chapters Five and Six provide detailed information on the 
logic of the executor and the construction of tables. 

Volume TV; Definitions of Diagnosis Related GTPUPS £0X 

Technical Use. This manual is similar in content to vpIpiup 
II : Definitions of Diagnosis Related- Gtdhps but there are 
some distinct differences which are designed to aid 
programmers in following the flow of the grouper logic. 
These differences include: 1) no English descriptions, 2) 
the DRGs and their criteria are listed in priority order, 3) 
the list of codes is more extensive in that it includes both 
blank and zero filled codes. 

Volume V: Transfer Tape for MEDPAR Diagnosis RelatEti SXQUfi 

Assignment Software MEDPAR Version pj£ ttlE HEJ£ lCP-9-Cfl 

Diagnosis Related fl-raup Classification Scheme and 

installation Manual. The MEDPAR transfer tape contains the 
software required to assign a DRG number to a given patient 
abstract coded in the standard NEDPAR format, (the MEDPAR 
format does not include secondary diagnosis, and discharge 
status which are required in the 467 version of the ICD-9-CM 
DRGs) . This software incorporates modifications to the new 
ICD-9-CM DRG Classification Scheme that were required to 
accommodate the limited elements available on the MEDPAR 
dataset (e.g. MEDPAR DRGs are subsets of the new ICD-9-CM 
DRGs) . An installation manual similar to that in Volume III 
is included with the tape. 



***ORDER FORM ON REVERSE SIDE 



Order Form 
ICD-9-CM Diagnosis Related Groups 
Health Systems Management Group 
School of Organization and Management 
Yale University 



Unit Price Number Total 
Ordered 



Volume I: $ 50 

User Manual for ICD-9-CM 
Diagnosis Related Groups 
2 lbs. 13 oz. 



Volume II: $150 
Definitions of Diagnosis 
Related Groups 
8 lb. 12 oz. 

Volume III: $300 
Transfer Tape for I CD- 9- CM 
Diagnosis Related Group Assignment 
Software and Installation Manual 
and User Guide for Technical Use 
2 lbs. 4 oz. 



Volume IV: $ 65 

Definitions of Diagnosis 
Related Groups for 
Technical Use 
3 lbs. 5 oz. 



Volume V: $300 
Transfer Tape for MEDPAR 
Diagnosis Related Group Assignment 
Software MEDPAR Version of the New 
ICD-9-CM Diagnosis Related Group 
Classification Scheme and Installation 
Manuai 

2 lbs. 1 oz. 



TOTAL $ 

HSMG does not provide technical assistance for the above software. 

ALL ORDERS ARE SHIPPED BY FEDERAL EXPRESS. FEDERAL EXPRESS WILL BILL 
YOU DIRECTLY FOR SHIPPING CHARGES. PLEASE MAKE ARRANGEMENTS THROUGH 
OUR OFFICE FOR OTHER MAILING REQUESTS. 

Material will be sent upon receipt of your check made payable to: 
Yale University, School of Organizatin and Management 
Health Systems Management Group 
Box 1A 

New Haven, CT 06520 

Date 

Name Phone 

Name of Organization . 



•Address, 



City, State Zip Code. 

•Street Address (P.O. Box Numbers Are Not Deliverable) 



Yale School of Organization and Management 

BoxlA New Haven Connecticut 06520 



TO: Colleague 
FROM: Ann T. Freedman 
RE: Corrections to the ICD-9-CM Executor Program (Grpexec) 



A proolem has been identified with the executor program 
(grpexec) you received from the Health Systems Management 
Group of the Yale School of Organization and Management, The 
error showed itself in the form of addressing interrupts, 
and did not happen at all installations. Indeed, the problem 
never arose during all the testing at Yale because the 
manner in which core is allocated would not cause an 
addressing exception. All tapes created after February 2, 
1982 contain the corrected executor program. 

To clarify how corrections should be made, the following 
narrative will show the page number in the installation 
manual, the code as it appears on the page and, below it, 
the corrected code. 



The executor should be compiled with the 'NOALIGN' assembler 
option after making the final correction, and re-linked (see 
Chapter 3) if using the grouper utility. 



1. 


Page A. 3 - 


the 


fourth 


instruction from the top 




original 
change to 




MVC 
MVC 


SAVDXS,=F'l 1 
SAVDXS(4) ,=F'l 1 


2. 


Page A. 5 - 


the 


third 


instruction in the routine ' CLOOPA2 1 




original 
change to 




CLC 
CLC 


GSDX,=X'00 1 
GSDX,=10X'00 1 


3. 


Page Ab- 


the 


eighth 


instruction in the routine 'HIT' 




original 
change to 




CLC 
CLC 


DSG,=X'00 ' 
DSG,=20X'00 ' 


4. 


Page Ab- 


the 


first 


instruction in the routine ' DXFILL 1 




original 
change to 




CLC 
CLC 


DADX,=X'00 ' 
DADX,=10X'00 ' 


5. 


Page A. 7 - 


the 


first 


instruction in the routine ' DXFIL2 1 




original 
change to 




CLC 
CLC 


DSDX,=X'00 1 
DSDX,=10X'00 1 



385 



Yale School of Organization and Management 

Box lA New Haven Connecticut 06520 



TO: Colleague 

FROM: Ann T. Freedman 

RE: Dump of Corrected Test Database 



I have received several requests to provide a dump of 
the corrected test database. Therefore, I am' enclosing a 
copy of the corrected dump. The four records that changed 
due to corrections made to the executor are underlined for 
your convenience. 

If you have any questions, please write to: 

Ann T. Freedman, M.P.H. 
Yale University 

School of Organization and Management 
Health Systems Management Group 
Box 1A, 12 Prospect Place 
New Haven, CT 06520 



386 



041P 

5- =33 V*tiO 


86688622BS52S744882780 1 68324 


CA 1 * A'. 5 * GnflCCQ 


ec ^5 -97884718 


aS0497l5 c l" 7 lS173 




7P' i 1 4' PI CO 
•.0 4 1 *t » 1 C V 


(V ' 3 S 7?70l 

• J . w 3 /to/vl 






□ to4 ftotol 








7C 1 i"" ! SO 


7>*06 7890 


9218 


8879 




7406 -0*3510473 


3838 




/ V to « Tiw* 3 V 


0"- 49 7040 






144+1 / .SU 


1 i 41 U4581 


8033 




C?1 1 d^ll so 




9339 




Sa?1 41 R1 £0 


7FSW7849 4580 5589 2554 






741P"'7 ^0 


WW -J 






PI 1 741 P0 
Slltotl Ov 


78559563831537 7S19 


4610 




R1 1 P4RP C 04R1 


015 






547 1 ^73 90 


05 






1511 ?79 CO 

131 Ito/ 3 wU 


725596 159 9965 £8738506 514 


5185 5411 


6309 9?02 Q 2058B76 


7171170 505411 

toltolltoU jUwiil 


0">n 0410 4409 






751 1 777 P0 

/3 1 1 to 1 / JU 


U110 590907910 75000 

WW*-' VlWV JdVOV/diV WWV 






?7?1'?4l0 SO 
to/to^to'rv Ov 


7-559750707954 0411 0419 3998 


84159163813381738952965891838888 


5P*>'; 1 < 1 50R41 5 

^Q4.4 44j WVQtI^ 


7£^5P4109 4140 4409 2765 

/ wJ31 1V3 "Tl tV tTvy to /WW 






P4?Q-!?1 50 4 


75090710,9 1177 


9979 

OB 8 O 




1R7i 7P41 00 
<JOto 1 tout 1 W 


77K0 7795 5990 0419 7919 

£/Bw J3dv Vrlu /31w 


8965 


89199929 


P0747PR 1 OO 
3Uto*tto30 1 W 


75010750707954 44*391 4510 0991 


4820 84118622 


349 1 99299977905 1 904 1 9041 

w^w 1 OOlOOQUWVv 1 JU" iSvtJ 


R771 7951 00P41 1 
Q /tol toQJ 1 Wo* 1 1 


750 1 1 750S 1 3371 


8965874491319132 




1917795100 

19l4lwi^lVv 


7R19 U67997934 


90919092 




771799100 

4ll63elVV 


7779 
<& / <b 


0115 




1771 7911 0001 1 5 


75070441917079 1540 1990 4019 


4290 8622996593329929 


91619163 


R41 1 7971 00RR77 

D*tll£0/ 4VVDQto& 


74 i 1 779 

to"* 4 X totoU 


062 




4371790100067 


7449 7140 
t**Ta / itv 






4071301 100 

'TV £ 1 ij V 1 1 V V 


750707854 4419 4407 4409 4400 


4018 39253818 


3929994939238848 


591 17971 00191 fl 

JOI ltoWtol UUuolQ 


7&49 4019 5997 5990 479.1 5199 
&***ta TV 1 3 333/ 333V T6SO 3XOO 


8773 




R571 1001 00 

03to 1 u Uv 1 '."J 


750501R7071797118041 41 7 


1474 




5911 47 201474 


1387 2959 U1052 

IwO/ 4wwu Vivv6 


07228962 


9845 


79212861000722 


7-05 1 1R7071R 191 7504 1 59 1 9 1 

ivww 1 wB<& UtoWB iOl^VH 1 3B 131 


14491452 




1111 IS ?0f449 

Will WW «.vl11J 


75- 1 77R 49R 45991 

£3toV totoS *»3B 


0689 




91 21 7RP 1000689 
o i tol toOw i yuvooj 


777R 






15717PP100 

WWtoltoWWl VV 


750501R70 11R59 75000 


12721691 




5171 39 701272 

WWtal WW toVlto/to 


77K7 7999 
to/Oto £333 






131 17P7100 
wwi i£w / i vv 


750501R7071R04197911 1RR1 7 


14239512 




671 1 47 70 

O/ 44 T / to V 


77flO 417 47711 


539 44695012 




441 17991004469 
n 1 1 toOu i uviiyfl 


750501577- 4419175070 
WvWJS/C *T*»w31toVV/V 






7974 49 70 

/Wto+ M W toV 


7597 


067 




?32 129 1100067 


750501RR4 1 1G7rt 1 


1319 




4R71 19 701119 

1Q14 WW toVlwlw 


ill 0R74R7 


064 403 




?81 1407170403 

iTbw X X ~V / X / v~v\J 


U i 0P7 
V i <JB / 


4021 




37714081704021 


77701 


8521 




IJtJ^OwiwV fr- 


mi 0P7U5P0 
V 1 UO / V3BV 






it 1 141 1 170 
XXXX"TXXX/V 


V181 6262 V201 


685 654 6909 




3371461230685 


250502780 4049 5210 71590733013620138218761 


8211 


7171 40 ?03821 

/ XfcX ~V «>vwUfa X 


V779 






3421467230 



7701 



387 



2.32 2225 5cG35c30S 4i4C 

8t,504SS402£3150 

2i30 2732 4452 552107101 

£.50425001 

SS-3 5272 37200 



415 5061 8744881 S877S549S9 131335298073783 
£302385237-4 

4011 
415 

470 4011 



2M6 2838 
2S51 
2-32 

2&.-I2 

1640 7953 4482 
2&.3Z 4319 
2832 V222 
2832 

7a 12 2825 250006820 3033130400 
2B32 5800 56383 
16*0 1370 2333 2875 2880 
2030 330 £87922765 2853 1120 
1SGS 1376 1385 
V581 1830 

2050 2853 3823 VI 051 
200137856 28353574101519 
1390 VI 084 
1882 VI 0475433 
20168 

V550 V1063 
V711 V1005 
2-0215390 0416 
30000 
2589 

3004 5633 4558 2780 V453 5358943330 

3013 

309283016 
30o4 303007525 
3133 8443 
2582 3033 313 
3102 3221 733334273 42783 
3102 2765 3103 716903669 36900 
648413181 
3102 

3102 2281 852208 1000EB8 10 
64343 
3102 8730 

423 4140 E87685330 0414 938 
85225851058730 8 120084234E8 1395990 311 
85-10 1 87343E8 1 5030500 275 1 8954305587 1 7 

8C002EB147 8954 



470 4533 

3425340230413043 3324401 13202S205 

470 8334 

471 5411 

470 456254128763 3764 

30413043313131329052 
876187S991319132 

802 5732330457343764401 188344524441587738826 



437 415 51225011 
8838 9925 
4029471 
9925 
9925 
4524 

88759201941 19131913383653041 



0331891490029132 8703 



623 627 

9444 

9132 
741 

0131 

86518722 

03318952579487448131887231338365 

863 86638826872287038773 



i8EZ*4 /Qi03 
4121232150415 
5321235130 

521234150401: 
11 1 1253150415 
1311157 50470 
2521339150 
1611235150 
5911298160 
211337130 
1421150 60 
5411183 60 
1521158 504533 
58214061703426 
4011188 50 
2221156 60470 
1621171 605411 
2511325110 
1311148 604562 
2228413170 
5621403170 
33114011704011 
5821410170 
6818404170 
5421400170437 

311414170 
28114021704029 
1521405170 
1011409170 
7921412170 
8516429190 
3011425190 
1825430180 
3821426130 
2812428130 
2121427190 
3611424190623 
1811431180 
2414432180 
2111 25 10 
7321 24 10 
2726371140741 
1611 26 10 
7311 2 100131 
2421383140 64843 
1711 8 108651 
7528 14 10 
4416 7 108669 
1916 29 10 
211 30 10 



388 



oci c'?Qr>eA7qi 7R1 FP1 QP4P74 sqao 


(141 R CIEA7GQB e ?Pa'n'?n7iliin7" 
vfXO SOU / 330 J_3 frHO • — 


2996099919131913390525794 2219 


2.1 


10 


p--. ?ai ^'^-'dP inw 


P71 7P~""'R77i 




if) * 1 


31 


i o 








277 * 


*^7 




w-.' ;3«»5DSl 






3slb 


3d 


10 




7q«"i7R7??R7' ~PP' 1 7 
/ SVJfi / te«.u / 1 / SOi. J 




ual 1 




10 


il ^ ~ Tl 


A771 C1 71 Q.1 77CAA1 GAA 


■"7 


07 1 


Zl 


4 A 

10 . 


DC .-7 ?S7fl?fliWn FRRR 
3w- i CC/o£3vw>U COOS 


07q7r"i771 
VJ3 /UJJ1 




AI 4 
011 


*♦ 


100227 


4.^*7 4777 AA1 q 7*saaa 

fuvJ tg/g *rV10 wVVV 








15 


10 




Q777 


97173722 


291 1 




- ij 


T54fi 4fi1 a 417,0. 7Sfi A .077fl A . 


04438073 




**A7i 
DUtel 


fa 


100443 




033 1 87248723900 1 300286 1 1 9 1 3 1 8702 


P7 1 O AA 1 1 
3£i3 'Hfll 


J4 


10 


7'.c;4 ace? FR7R7 

JJ * *r wgQto CO / Otf» 


0242 




021 


J 


100<.4te 


R c r1 PR1R? 






1311 


77 

JJ 


1U 






4513 8954896587448722 6718 


a 

3 


1 A 

1U 




S721 




5811 


lb 


1 A 

10 


7Rfit1 7PP7 41 Art ?S A .Art 






7511 


77 


* A 

10 


4771 77«C7 *?qOfi ft.414 11107 
te*.Jte 333V WrlT vluj 




PR/1 1 P7rt7 


6621 


4 
1 


4 AA 1 7Q 
1001 J 3 


4~ii3 4771 7A7Q AAOQ qRPS 
•tw -' 3 tJJl J*Tte3 TtUs 33D3 


3812 




7111 


D 


1 A70 1 7 


7?n7 A7R1 7iY3flnuifi A SS717 7719. 


785599838 


0QC7OQC1 


5113 




1 

1U 


47 "51 SP71 fi41 4fi 
*tw / 3 gyi.lvti'tU 


8838 




7921 


4 "T 
1 / 


1 A 




8721 


8838 


4721 


1 7 
1 J 


1 A 
10 


77;'<i ASPft 7770,0,7771 PQ7R4 
JJlU tSDU /ggUVfggi C3J>D*r 






7821 


1 7 


1 A 
10 


iqo-5 ic7q ma's 4Q17 cam 

J.3DJ JLO/.S glOJ tSl£ OSJV 


33243322 


8838 


5221 


10 


1 A 
10 


4*571 7Af1 4Q1? 407R0A1 7 


8838 




7711 


1 c 
lb 


1 A 
10 


Vi'ia 771 Q1 7"<OOOAqfi 


9214 




6321 


18 


10 


CCR747A4C1 744.7 


8721 


88768873 


2321376140 


1Q17 
laid 


9925 




3311 


11 


10 


CCP71U770 


736 




3121372140 I 


37203 


9512 




021 


48 


20 


378523572 585 583814292 4402 2859 3995903190328744 


3512 


6721 


45 


20 


74235605 


0943 


640 


011 


41 


200343 


9213 






1211 


43 


20 


1909 


1649 




7421 


37 


201643 


370004019 37931 






6821 


44 


20 


1611 1610 1613 9995 EB786 


303 96079173 


83658952 


4321 


43 


30303 


360223829 


033187088001800280319032 


1121 


74 


30 


470 4781 


215 2197 




4211 


55 


30215 


4659 48390 


8865 


8748 


3011 


63 


30 


87201E9688 


184 8622 




4711 


63 


308622 


7847 494 0416 2761 496 1370 303905794874480418043 




6411 


66 


30 


475 


280 870830319032 




4521 


57 


30230 


4644 3829 


8365 




221 


71 


30 


462 3340 250103694 


8865 




2821 


68 


30 


4S71 0222 






1721 


70 


30 


2102 496 0436 


2623 




6511 


51 


302629 


872S1E88084280 30380 


88238717 




6612 


73 


30 


385303823 3458 


134 2043 




1321 


53 


302049 


470 


2188 




2311 


56 


302199 


4741038110 


283 2001 




411 


58 


30283 


749207481 


21852763 




2111 


52 


302763 



55135 



389 









211 67 


30 


JC -04/41i 


iQOli.91 1 




621 62 


302001 








3011 34- 


30 




2531 




5211 50 


A A Ann 4 

-0iS31 


oc ,307304 4i./oa 






70il 65 


30 


jc 3 385j0 


i04il24 




A 1 4 C A 

91a 54 


n An A il O 

30i042 




i.171 




2811 72 


30 


J00/B55 


i.OOli.001 




n^n 4 n 4 

2721 01 


A AAA A 4) 

30^.001 


A "~ * A 

4. ?0 


282 




1811 53 


20232 


4, 47410 


inn 

283 




611 60 


30283 


410i 41^. 4019 5330 0410 4ZS0 


8964 


DQCIOOC/lflT/l AGO* A 

8952835487448819 


■inn 4 4 n 4 

7321121 


50 4102 


41.1 4013 4143 


8954895^. 




5421 140 


50 


4.. J 12761 Z7BB 42783 


B95dB954B9658744 




■»nrt 4 4 n A 

7821138 


PA 

50 


4540 45981 






nn 4 A 4 n * 

2211131 


50 


45-3 4598125000 


3859 


9919 


4511119 


503859 



40:0 431 4280 4829 27S5 250005781 37218952874491319132960490010331909287039052 5924124 50 4280 

45c3 427894359 4263 3109 8952 7424144 50 

4109 412 4139 3723 4611122 50 4109 

7BS50412 0728 37238952 5521125 50 

443392765 42769412 438 6011130 50 

45 119 88668744 5311128 50 

4402 4912 3929 89655794 6611110 503929 
4442225010038425990 0418 5225 303913803 8405 8872882289658952 5321112 503803 

4104 4280 436 377287448952913191323786 6711117 503786 

42731438 2900 8872 8965 6521139 50 

78B50 895289658954 6315143 50 

4440 4401 3925392457948744872489548965 6621111 503925 

42731427815589 37749978 8121116 503774 

7802 5845 2765 4019 2761 5990 0418 8872 8965 9203 89529131 7524141 50 



4275 3481 481 4279 40210585 
402904140 6101 2721 
3952 4294 

4140 438 3421 2780 496 
4111 4118 VI 0059971 
936014260 4140 



8964579487449132904393929604896589629960 
8838 8876 8777 

352239613964896189629205 
9215 

3613396189618962 37228853 
3785 



3403 



3403370 8872 



372388533322 3481 



4140 412 427319981 9989 4294 420903613396189628961 
42S4 4019 412 045814239 9215 
4111 4140 3952 4280 2449 9973 0418 352236123961 
7B02 402904140 79431782620088 8838 
99B1 60945732 
9931 1519 01004 

4210 0410 8773 
7455 2851 3571396189618962 
9£31 2100 
4241 2384 42789412 8871 
4232 4019 4401 8845 

747107454 7470 4280 5134 7706 9981 3864388539619904990334023931884288723723 
4230 3918 486 4266 4270 377399749976 3772 377299623723 

7854 730279912 841193999339 
4240 8872 



8872 



6728129 50 
6021134 50 
5821105 503522 
7721132 50 

6611106 503613 
8721118 503785 

6611107 503613 
5421145 50 
5621104 503522 
6111142 50 
63114432106094 
7621452210 
5511126 50 
1721108 503571 
2311453210 
7711135 50 
6721133 50 

011109 503885 
6011115 503773 
4411114 508411 
3221136 50 



390 



SjSI 5070 4349 9993 

JUU i w V / V - w i w w W w 






3941 5392 


75234422102541 


4-'. 7 3 40591 






3924 


1S213051 103524 


9714467124 






397 9215 a a 07 c; 7 Q 4 




140267 










2S2133-- 


:40 


E •• . 22 






7534 


2521373 


140 


5 V 1404011 








6321463 


140 


6"/10lS7l 110270 0252 






5632 73S 


2521274 


L406S22 


S-J5 17454 






741 


1321370140741 


9381 £8788553209972 45111 




75918622^359 933S91B3 

/ W W m W hmmmmm i-r WW w wwwWW-kUw 


52214402108622 








89S5B744SS52904 1 904363 7290559 1 3 1 9 1 32 


6121 88 


40 


4_._.3 i/Ow /U/U 






0331995299658954 97449042 


7424 S3 


40 


Si 13 DcO _.DU41_,_>Ubl_!J/l 


2505 1 3620 1 3424349 1 92 1 88744904 1 90423995 


3311 85 


40 


bbu4 obi.ilo.__l allUvDwUb 


907098799 


J4U4yb«J49bU /89bZD 794349 1 93538960 88^7904 1 


1A4 4 n a 

-.011 94 


40 


4t J3UV_,Jo 






o9bD 8878 


2221 96 


40 


4b5 i/bD „UU3 






a 7449 13191 3290S 1 905Z 


111 91 


40 


4Cni *7QriC OT1A T0 1 A 

43<-l /sub JJ14 /331 J314 






0j31B9d58354SGQ5900Z3S63939_.904._313._B7038744 


011 81 


40 










011100 


40 


4b_.l /331 43b vlUilV44U 






995_,8954BSb5941 1953587449043 


S/i.4 79 


A A* 

40 


Dill 7b05 D77_. 






345 1 904 1 90439046895 i.332287448954 8965 


A i\ 4 4 "7 CT 

40 1 - 75 


403451 


7bo097803 -75*. 






0j31900-. 95072093 


021 S3 


40 


tbjgOSSoi £.2060313 






n« n< n< f"»n 

91619162 


2311 97 


40 


cbOl 88003E9bb 






3404 


4911 95 


40 


4bwU JB.,3 








311 98 


40 


0712 1330 






33Z3904 19042 


a n 4 /\ 

4021 80 


40 


99121807099248 EB192 






M 1 A n O O n it 

87438824 


5011101 


40 


1629 1960 2765 7906 2809 






896587449 1 3 1 9 1 32 


6111 82 


40 


4151 4820 2859 427314019 


438 


3429 


921 5874488278952 349 1 90468965904 1 8872 


8511 78 


40 


481 2859 3019 0971 






874490419042 


4121 90 


40 


5119 1739 01072 






34913424861 1904190428965 


5711 86 


40 


1E23 1960 






4011 


7711 77 


404011 


5194 






3322 


CP 4 4 4 a n 

5611102 


A A 

40 


5133 9349 496 4140 412 


438 




nnn m 

3324 


"inn4 nn 

73^1 92 


40 


5133 6929 






3324 3611 


n 4 n 4 an 

5121 93 


A f\ 

40 


5185 9952 303903317 3579 


3594 


5990 


nnn* nnn 4 nnnm nn 4 4 nnA^ nnnn 

995193919383 9211 9907 9295 


5914 97 


40 


1629 1993 3449 4019 42789786097906 


3322341 992587218716922793124131 


6011 76 


40341 


80?4 873408730 £9121 








4521 84 


40 


86132952168603 E9650 






8842 


5526 83 


40 


55090 






5302 8744 


nn 4 a 4 n 4 

8314161 


605302 


0553 5180 5119 2851 






4652 89658819 


3911152 


504652 


5243 9050 £9290 






7865247 


2121169 


607665 


5789 570 5711 485 5184 


2851 


5990 


45139131913291339091896590929392 9607 


4018174 


60 


5225 5821 






270 90519052918191838703 


2311168 


60270 


5589 2765 4476 






8611 9133 


5821182 


60 


5539 462 2765 








1711184 


60 


5225 






23033031903291819193 


3111187 


60 


1512 9985 £87864019 5845 


2148 




437 415 544 96049607401191318965 8764 


5311154 


60437 


0553 






4652 


1811153 


604652 


55090 






5300 


1411163 


605300 


55090 






5300 


2411162 


605300 



419-177 O - 



84 - 



- 26 



391 



7320, 30002 












5721.23 


2u 


3 ■ }0 






S724 








20 


s. 255623228: 12225512521 




456-4b7j4675471 o44 


86020*0467732275250 72 1 22 


1621:43 


504552 


5-031 






545 38 i 2 








50345 


5"' 32 












3511175 


3U 


5c 035V 102 15509250 70 










2211120 


50 


5;*S21V4381 






5359 






7211152 


£05252 


5:-5 3561 












5011172 




5JZ502S51 3320 


4140 412 


42. 8acS3S 








8115175 


£0 


5 :321V 103 VI 005 




5259 






5321150 


505359 


15-5 5192 486 


V1003V453 










7413172 


50 


5c' 36 56031V442 


5715 




4641545 431 501289524823 




2221 150 


60545 


5372 3558 4912 


2859 




540 


9il 467735213 


B87boe7b 


7221170 


60540 


2114 5693 40230V1006 




48638962 


48^.548i.48B7 < . 




3811146 


5048G3 


5400 






470 






4621165 


50470 


57-^9 562107140 


2800 2113 




45414524 


4524 




7321157 


604541 


873546820 0411 


5293 










7111135 


50 


;_;0 4140 412 


428C 4279 


V10932001S470 8352 


8876 




8211154 


60470 


15:3 1362 '.'101128959 




43998362415 






5311155 


604333 


1540 V1021 






485 






5511147 


50485 


531905770 






44138876 


8338 




7321177 


so 


533907140 2809 






4413 


8762 




4121178 


60 


1504 






4224 






5711173 


60 


1120 7834 












011186 


50 


1701 






7631 






4521234 


807631 


7505 






433 8762 






011156 


60433 


V535 5206 






97332319 






2211466230 


5711 2912 303915990 0416 


2859 


8744881331335734 






4311202 


70 


5722 2859 702 






3212300288268827882832023166 




4322206 


70 


574205756 






51228753 


88748754 




1321137 


705122 


1977 5390 0411 






5033053 1 50 1 288478779887687629 1 339 1 4 1 


2321133 


705012 


5722 5712 5799 


2800 5990 


0414 0979 


838 


3633573483658362 


3428205 


70 


5770 303905990 


0414 




83653607313131338779 




5021204 


70 


5712 303914280 


495 




50 1 28876870387448762033 1 8872 




5611200 


705012 


57410 






51228753 






2321138 


705122 


1377 0103 4512 


2500057420 


92023205313131328828813131513214 


8365 


5321203 


70 


574205770 4019 


13101 




8365835436073132 


88768813 




6321207 


70 


57410574403370 






512251418753 


8752 8362 


8876 


7821135 


705122 


5751 5771 5761 


5768 1570 


03849 


51325113 


5291 




7724133 


705132 


1579 






522 


52918876 




8318192 


70522 


574204414 4019 






8876 






5611208 


70 


0063 5570 5845 


0383 VI 04 10062 


457346204613500 5431898489613333 


5412 


5628131 


70500 


5750 5679 570 






4342 






5711201 


704342 


574007824 






5122470 4513 


51415151 




2421126 


705122 


15S0 






51515132 






5921194 


705151 


5901030401 






3779 


91433133 




2921320110 


5389 6020 5640 


5390 0416 


2900 2765 


586 5732 


87738776313631334823 


8014328110 


585 59000V420 


4280 4293 




5563874431319132 


3221 




22213021105563 


585 402014290 


5780 2859 




33278744836531 1 131 12543836073335 




25113151103327 


3446130781 






5732 






2311332110 


5=5o 0S71 4S6 


702 




57325734 






81113081105724 


t>-j2: 7580 






87745732 






4511222 


110 


5cr30 0414 1706 


V1006V443 




033131215133 






3711221 


110 


525 7806 2S43 






29S5 


8875 




4621316 


110 


5c'97 7533 






573227749132 






2211222 


uv 


5294 5997 5990 


04l3 42733 


.412 2S00 


57228774 


89525794 




8514321. 


no 


5=41 4139 






5732560 






4711310 


i 10550 



392 



7883 S930 £9300 






5789 




352130S1 105789 


5H99 1889 SOO 


185 






5749602 5732586 




851430S110S02 


5c 20 








560 57328774 


5721 8721 


2921311110550 


5521 








8773 




2411324110 


537805990 598S 








. mm f— mm> mm f\ 

D85 5732 




3921312110585 


5583 








581 586 5732 




62213131 10581 


5a89 '.'1046 








58235732 


3218 


5811329110 


5521 5S20 V453 


2718 


53010313 


562 5732 


8773 S773 


2621304110552 


5c30 0414 












1721322110 


1ES9 7806 








9503 




5311319110 


1389 4139 4140 


496 


25000 


9396 




6711316110 


1830 SOO 8975 


7885 


3365 


5180 


5119 5551604 877487739904573293019203 9202 


73113031105551 


7533 5988 








586 8774 




621333110 


5997 V641 2859 


7883 










511327110 


2337 600 








5749602 




6911307110602 


5389 59789 








586 5732 




221330110 


5988 








581 




1311314110581 


V568 585 4039 


4433 






5498 




6321317110 


600 5960 








602 5759579491319132 


5311336120602 


6C0 42789412 


496 






60115732 


8354 


6211348120 


605 








6491 


91319132 


111350120 


7528 








6393 




39163391206393 


V502 








640 




011343120640 


7526 600 5983 


4013 






602 586 5732 




5111337120602 


185 1330 6033 


6083 


4149 


4118 


6241631 




82113381206241 


8782 








6141610 




2711352120 


600 53780 








5732586 




5311349120 


60 784V 1046 








6495640 




60113411206495 


604906039 








631 623 




1711340120631 


135 M10515953 


3501 






602 57495792576 57329218 


8611335120576 


600 6028 5941 


5368 


7882 


496 


603 57196373572157328777 8962 


8411334120603 


185 600 








6011 


9214 


8011346120 


185 73399 








57326011 


9214 


5811347120 


185 600 4929 








6011573260948774 


9222 89653331 


57113441206094 


5071 








640 




6811342120540 


600 5989 








6061566 




75113451206061 


V252 








6373 




3011351120 


l .'252 








6632 




25213591306632 


6200 0141 








5561542187445794 


8965 


33213551306561 


0980 6266 








6909 


91419142 


19213641306909 


V252 








6629 




22213621306629 


09817 








8876 


91419142 


2022368130 


6278 319 












5026368130 


31 • 2 5580 








5421 




2721351120542: 










672 6509 




2521253130572 


6255 ;'i042 








595 




6321356130555 


2.0 5170 2189 








534 6561471 




4721255120=34 


5253 6224 








7033 


670 


352 1380 1307032 


1320 2189 








584 6561544 




7221354x30634 


1 7° 








5513 




3121366130 


1320 1990 56089486 


2888 


7070 


0383 5411545 4552463346 105 5238365 


61253651305411 


1S3825501 486 


5330 


3966 


9985 


0388 688 545 46135671333387733231 


« ^ . ,-\ /"^ o o 


1805 1960 












5721267130 


2362 V252 








654 6663 




3621357120554 


033 








8878 


9132 


1821279140 


2 








6302 




20213311406502 


S2471 








6351 




2721380140 


5-- 412 












1721382140 


6331 6143 6141 








6662 


8878 


1821378140 



393 



6b 95 1 'J 270 SS33 12165 

2L27 250102762 4019 

SO:. J ESS03 

SS2S 4280 496 4439 

6110 2780 

2148 

1740 1963 49390 
9Z22 E9500 
92410E818929560 
V51 0643 

872498748 e750 8792 
8/5., £966 30392 
S3 20 0410 

1744 496 4019 4292 

665 

7092 37446 

l/Ai 1990 250004019 

6111 

1744 1963 

053c 

6822 0222 
053b 25000 
707: 7103 
61:0 6159 0414 
17*3 4280 
lSc.1125000 
GZC- 7140 

80S0 £888 5990 4010 
SZ022ES88 5990 0414 
72741 
730185642 

711066825 0410 600 
3251 825386942 3756 
B054 £882 30391496 

£'-. -2 £355 3944 73303 



6187 

303905990 0414 86229163 
8669 



721 7534863 4878 



8794 E9651 



2500001042 



4524 
8521 
8339 

854391319132 

9202920587798723 

91819182 

8799874487178722 

8622 

8622 

8543 

8621 

86840870 
85213404 
8532 
85438521 

540 



8386 



89858828 
8764 

8827 

91619162 
3491 

9202 9218 



818680737763834282579354 
25000 88268305833987449132 
250002851 0625 7935913191329133932289656952 

8221 

77430523 7748 033130068191 

344615968 81818604874488188151862296598965 8658 

3241 8261 £3122796786228655935457947937836489659339 

87229324 

753168219363913191238852 
' 73678323 



71=456*42 £310;; 

b-. ■ •68X320S100082530S250 373428730 
E:344E8B8 
'/- . iS 

EIZIOESSJO 
8442 8441 EB1S2 
S '535E" : '522E5550 
7-0186539 
72210499 73390 
5.44 £8261 

SJJ64 £87886624 58100 
8Z101E9869741027422 7330334461 
810038110180702831098501 9189 E81899 
81241E888 5712 303912809 495 
7335229562 
72210 

730076627 0417 8921 £91792848 

730182503 

821018441 8442 8448 £9688 

82 02 1 82 1 3082302823929044 1 8082 E82 1 7383 1 83 1 48848 
8124383203E8860 7931 
715265990 4149 9147882789529322 
730176827 0417 78077767 
2740 819191519152 



79327938 3S21S722 
7902 
0451 

9353 55273324 
31918016 

9353 9823 
91519152 

805 89548565 
790693398528 
8604883531719172 
921488269344 

596821 
731288228821 
8162 

805 8724 
86047714 

841793248827915191538191 
7935882489659324 81458146 

831493449042872489658954 



78697767 



91319132 
88269162 

8601862288289161 



4921253 
1011266 
7111283 
3221262 
3121270 
4621258 
1811281 
4316280 
2421284 
1716282 
4011265 
111264 
7721257 
2621267 
2511268 
7521259 
3721261 
5721260 
5721273 
2221269 
9311272 
4221271 
2021276 
5521274 
6221275 
S221227 
8114236 
7616210 
3221228 
4411216 
6714217 
2311225 
5611243 
5621213 

22:122: 

2011247 
2221224 

3511255 
4111254 
2511222 
2511251 
4411238 
3311214 
1121255 
5521245 

121235 
4511253 
5321223 
2711209 
5111215 

311229 
5211213 
4611211 
3113226 
1511220 
6721221 
3411218 
3211245 



1404373 
308622 
308669 
90 

908521 
908339 
908543 
80 
90 
90 
90 

908622 
308622 
908543 
908521 
908684 
908521 
909532 
908521 
90 

90540 
90 
90 
90 
90 
90 

808342 
80 

807935 
808221 
807748 
808622 
807967 



80 

807821 
307857 
30 

507922 
30 
30 
30 

505015 

30 

30 

30505 

30 

SO 

80 

30 

307812 

808162 

80805 

807714 

808417 

507935 

308314 

807931 

808147 

807807 

80 



394 



0540 7865 
7177 9597 EB191 304032780 8026 

7 l 536427690 1 0465932 89758773877787448827895469659322 
8245 8371 802388025 8027 8020 8735279399324 76767672 



821018505 8910 81253E8147 
1535 2038 

5SS7 9382 9042 25000486 2743 600 

71/41 

513419052